Individual provider Active NPI

Jennie Yanling Zheng, MD

  • Family Medicine Physician
  • Bullard, TX
National Provider Identifier
1043846090
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U3390 Issued in TX
Practice address
435 Doctor M Roper Pkwy N
Bullard, TX 75757-5117
Phone
(903) 894-3991
NPI assigned
Mar 20, 2020
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X U3390 TX Primary
Family Medicine Physician 207Q00000X 335343 LA

Addresses

Primary practice location

435 Doctor M Roper Pkwy N
Bullard, TX 75757-5117

Mailing address

435 Doctor M Roper Pkwy N
Bullard, TX 75757-5117
Phone (903) 894-3991

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710000371 TX Practitioner - Family Practice 9739598160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

435 Doctor M Roper Pkwy N
Bullard, TX 75757-5117
Phone (903) 894-3991

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U3390TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Jul 1, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jul 1, 2023 Accepting new patients
Starks Medical Past Accepting new patients

Locations

435 Doctor M Roper Pkwy N
Bullard, TX 75757
Phone (903) 360-6846

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

3753 Earl Campbell Pkwy
Tyler, TX 75701
Phone (903) 747-9550

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1043846090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 DOCTOR M ROPER PKWY N",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575117",
            "telephone_number": "903-894-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 DOCTOR M ROPER PKWY N",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575117",
            "telephone_number": "903-894-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHENG",
        "first_name": "JENNIE",
        "middle_name": "YANLING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U3390",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "335343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullard, TX

Sources for this page

Verify at the official NPI Registry.