NPI age
20 years
Enumerated 2006-05-24
● Active
Type 1 · Individual
Jack R Childress, MD
Childress is 1 of 1 internal medicine providers in Lake Kiowa and 1 of 12343 in Texas.
Primary specialty
Internal Medicine
Plus 4 subspecialties
Licensed in
TX, LA, WY, GA
4 states
Status
Active
No deactivations on record
Last NPPES update
2025-06-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 12343 active internal medicine providers in Texas.
NPI age
20 years
↑ 3 yr above median (17 yr)
State licenses
4 states
Top 88% — 12% of peers are multi-state
Subspecialties
1
In the 33% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-05Enumerated in NPPES
2006
2026
Where they practice
Practice location
105 Sequoya Dr
Lake Kiowa, TX 762409446
Mailing address
105 Sequoya Dr
Lake Kiowa, TX 762409446
Additional practice locations
3 secondary locations on file with NPPES.
Location 2
400 S 15th St
Worland, WY 824013531
Location 3
5995 Spring St
Warm Springs, GA 318302149
Location 4
1900 Main St
Franklinton, LA 704383688
Specialties
-
Internal Medicine PrimaryA 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,...
-
HospitalistHospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (AR) | 84487 | BCBS-ARKANSAS |
| 01 (TX) | 8V4246 | BCBS-TEXAS |
| 05 (TX) | 1140766-07 | |
| 05 (AR) | 163713001 | |
| 01 (TX) | P00466537 | RR MEDICARE |
Multi-state credentialing: Licensed in 4 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.