Individual provider Active NPI

Edgar Eugene McLemore Sr.

  • Home Health Registered Nurse
  • Tyler, TX
National Provider Identifier
1013417955
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
241548 Issued in TX
Practice address
755 S Beckham Ave
Tyler, TX 75701-1903
Phone
(903) 534-4684
NPI assigned
Feb 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 241548 TX Primary

Addresses

Primary practice location

755 S Beckham Ave
Tyler, TX 75701-1903

Mailing address

PO Box 1133
Pittsburg, TX 75686-3133
Phone (903) 635-4412

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
241548TXMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1013417955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1133",
            "city": "PITTSBURG",
            "state": "TX",
            "postal_code": "756863133",
            "telephone_number": "903-635-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011903",
            "telephone_number": "903-534-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEMORE",
        "first_name": "EDGAR",
        "middle_name": "EUGENE",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "241548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.