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JACK R CHILDRESS MD
NPI 1841245883
Internal Medicine in Lake Kiowa, TX

Active since May 24, 2006PECOS EnrolledAccepts Medicare Assignment
105 SEQUOYA DR, LAKE KIOWA, TX 76240(940) 736-8885(940) 668-8292 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 3, 2025, Jun 8, 2023, Jan 28, 2022 (3 updates tracked since 2022).

About Jack R Childress Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK R CHILDRESS MD (NPI 1841245883) is an individual internal medicine provider in Lake Kiowa, Texas, licensed in Texas (H5535) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Riverside Medical Center, and is a graduate of University Of Texas Medical Branch At Galveston (1983).

NPPES Registry Identity

NPI1841245883
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJACK R CHILDRESSCredential: MD
Location Address105 SEQUOYA DRLake Kiowa, TX 76240-9446
Mailing Address105 Sequoya DrLake Kiowa, TX 76240-9446 · (940) 736-8885 · Fax (940) 668-8292
Phone(940) 736-8885
Fax(940) 668-8292
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 1983
Enumeration DateMay 24, 2006
Last NPPES UpdateJune 3, 20253 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
✔ NPI 1841245883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in TX · H5535✔ Licensed in LA · 346502✔ Licensed in WY · 14502A✔ Licensed in GA · 97208
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License H5535 (TX)
105 SEQUOYA DR, Lake Kiowa, TX 76240
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Other Identifiers 5

Other84487AR · Bcbs-arkansas
Other8V4246TX · Bcbs-texas
Medicaid1140766-07TX
Medicaid163713001AR
OtherP00466537TX · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack R Childress Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739115494
PECOS Enrollment IDI20050713000965, I20231017002217, I20250605003090
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
50 services22 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
19 services14 patients
Nursing facility discharge management, more than 30 minutes 99316
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Riverside Medical Center

Critical Access Hospitals · Franklinton, LA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number191313
Location1900 South Main StFranklinton, LA 70438 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76240 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
99%193 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332
DME-Medical/Surgical Supplies · category DA000N
1 supplier12 claims2,160 services$0.10 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
2 suppliers14 claims3,060 services$1.73 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims330 services$5.38 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers19 claims19 services$91.17 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Childress's NPI number?

The NPI number for Jack Childress is 1841245883. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Where is Jack Childress located?

Jack Childress practices at 105 Sequoya Dr, Lake Kiowa, TX 76240. The listed phone number is (940) 736-8885.

What is Jack Childress's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack Childress enrolled in Medicare?

Yes. Jack Childress is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Childress accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Jack Childress as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jack Childress affiliated with any hospitals?

According to CMS data, Jack Childress is affiliated with Riverside Medical Center.

When was this NPI record last updated?

The NPPES record for Jack Childress was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.