Brent Talley, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Amarillo, TX
NPI 1043095235 · NPPES record last updated Nov 7, 2023
Key facts
- NPI
- 1043095235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 839764 (TX)
- Practice address
- 7813 Pebblebrook Dr
Amarillo, TX 79119-4923 - Phone
- (806) 681-2561
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240102003616 | TX | Practitioner - Nurse Practitioner | 6204286305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 839764 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Panhandle Family Care LLC | Current |
Accepting new patients | |
| Panhandle Family Care LLC | Current |
Accepting new patients |
Locations
1600 S FM 2381
Bushland, TX 79124
Phone (806) 310-9853
Interoperability endpoints
- https://api.platform.athenahealth.com/25616/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 839764 | TX | |
| Family Nurse Practitioner | 363LF0000X | 839764 | TX | Yes |
Addresses
Primary practice location
7813 Pebblebrook Dr
Amarillo, TX 79119-4923
Mailing address
7813 Pebblebrook Dr
Amarillo, TX 79119-4923
Phone (806) 681-2561
Other providers in Amarillo, TX
- Aisha Tahbib
- Nicholas Saffar Tahmassi
- Nibras Talib Mamury
- Talk Business Online, LLP
- Sheree H Talkington
- Louise Joseph Tan Jr.
- Gabrielle Gloria Tardieu
- Hassan Tariq
- Tascosa Emergency Physicians PLLC
- Brittany G Tate
All providers in Amarillo, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.