Individual provider Active NPI

Destoni Edwards

  • Family Nurse Practitioner
  • Shenandoah, TX
National Provider Identifier
1023513694
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1143889 Issued in TX
Practice address
150 Pine Forest Dr Ste 110
Shenandoah, TX 77384-5303
Phone
(832) 373-4392
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 941520 TX
Family Nurse Practitioner 363LF0000X 1143889 TX Primary

Addresses

Primary practice location

150 Pine Forest Dr Ste 110
Shenandoah, TX 77384-5303

Mailing address

150 Pine Forest Dr Ste 110
Shenandoah, TX 77384-5303
Phone (832) 373-4392

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
I20240111000965 TX Practitioner - Nurse Practitioner 8325499619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric and Palliative Care Associates, PA.Group PAC ID 8628366135, 7 clinicians

Practice addresses (Care Compare)

150 Pine Forest Dr
Suite 110
Shenandoah, TX 77384-5303
Phone (281) 709-2555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
941520TXMDRegistered Nurse
1143889TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric & Palliative Care Associates,PA CurrentSince Dec 28, 2023 Accepting new patients

Locations

150 Pine Forest Dr
Ste 110
Shenandoah, TX 77384
Phone (281) 709-2555

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1023513694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PINE FOREST DR STE 110",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773845303",
            "telephone_number": "832-373-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PINE FOREST DR STE 110",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773845303",
            "telephone_number": "832-373-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DESTONI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "941520",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1143889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.