NPIMap

Individual provider Active NPI

Brent Boye Nall, M.D.

  • Gynecology Physician
  • Lubbock, TX
National Provider Identifier
1043298094
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
F2818 Issued in TX
Practice address
4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone
(806) 744-7223
Fax
(806) 740-3325
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X F2818 TX
Gynecology Physician 207VG0400X F2818 TX Primary

Addresses

Primary practice location

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520

Mailing address

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone (806) 744-7223

Other identifiers 6

IdentifierTypeStateIssuer
8V8690OtherTXBCBS
P00395667OtherTXMEDICARE RAILROAD
4363146OtherTXAETNA
100215106OtherTXFIRST CARE
100215106OtherTXTEAM CHOICE CORE
116082206MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bnall1250180@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050712000713 TX Practitioner - Obstetrics/Gynecology 5092741967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9410
Phone (806) 743-3150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F2818TXMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Obstetrics & Gynecology CurrentSince Dec 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 1, 2024 Accepting new patients
Covenant Medical Group Past Accepting new patients
Covenant Medical Group Obstetrics & Gynecology Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

4004 82nd St
Lubbock, TX 79423
Phone (806) 722-3150

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432

Interoperability endpoints

  • Direct secure messaging: bnall@yourcarecommunity.org
  • Direct secure messaging: brent.nall@direct.myteamcare.com

Organizations & group practices 6

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 7

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1043298094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALL",
        "first_name": "BRENT",
        "middle_name": "BOYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "F2818",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "F2818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8V8690",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00395667",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4363146",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE",
            "identifier": "100215106",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEAM CHOICE CORE",
            "identifier": "100215106",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116082206",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnall1250180@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4515 Marsha Sharp Fwy",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794072520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.