Individual provider Active NPI

Carol Ann Jeter, WHCNP

  • Women's Health Nurse Practitioner
  • New Caney, TX
National Provider Identifier
1013078708
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
448594 Issued in TX
Practice address
21134 US Highway 59
New Caney, TX 77357-8373
Phone
(281) 577-8966
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 448594 TX Primary

Addresses

Primary practice location

21134 US Highway 59
New Caney, TX 77357-8373

Mailing address

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Other identifiers 1

IdentifierTypeStateIssuer
159333703MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
448594TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Medical Branch at Galveston Past Accepting new patients
Utmb Faculty Group Practice Past Accepting new patients
Utmb Faculty Group Practice PastSince Feb 5, 2015 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1013078708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21134 US HIGHWAY 59",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773578373",
            "telephone_number": "281-577-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "448594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159333703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Caney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.