Individual provider Active NPI

Jennifer Graxiola, FNP

  • Nurse Practitioner
  • Sherman, TX
National Provider Identifier
1013434307
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP134406 Issued in TX
Practice address
500 E Peyton St
Sherman, TX 75090-0200
Phone
(903) 893-6000
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP134406 TX Primary

Addresses

Primary practice location

500 E Peyton St
Sherman, TX 75090-0200

Mailing address

PO Box 644
Collinsville, TX 76233-0644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024002799 TX Practitioner - Nurse Practitioner 8224304985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenneth E. Anderson Jr. M.D. P.a.Group PAC ID 8921149873, 2 clinicians

Practice addresses (Care Compare)

500 E Peyton St
Sherman, TX 75090-0200
Phone (903) 893-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP134406TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Laboratory Services LLC CurrentSince Aug 1, 2017 Accepting new patients

Locations

500 E Peyton St
Sherman, TX 75090
Phone (903) 487-0598

Organizations & group practices 2

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": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1013434307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 644",
            "city": "COLLINSVILLE",
            "state": "TX",
            "postal_code": "762330644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E PEYTON ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750900200",
            "telephone_number": "903-893-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAXIOLA",
        "first_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP134406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

Verify at the official NPI Registry.