Individual provider Active NPI

Marc Reimers, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1053946368
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP144994 Issued in TX
Practice address
1905 S Donnybrook Ave
Tyler, TX 75701-4216
Phone
(903) 939-7500
Fax
(903) 939-7728
NPI assigned
Mar 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP144994 TX Primary

Addresses

Primary practice location

1905 S Donnybrook Ave
Tyler, TX 75701-4216

Mailing address

3414 Golden Rd
Tyler, TX 75701-8336
Phone (903) 939-7500

Other identifiers 1

IdentifierTypeStateIssuer
AP144994OtherTXLICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Flint
CONNECT URL Flint

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
I20201006003040 TX Practitioner - Nurse Practitioner 2264851559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipa ER Group PLLCGroup PAC ID 9133655616, 27 clinicians

Practice addresses (Care Compare)

1814 Roseland Blvd
Suite 100
Tyler, TX 75701-4262
Phone (214) 696-8033

Hospital & facility affiliations

  • Baylor Scott & White Texas Spine & Joint Hospital Hospital, Tyler, TX, CCN 450864

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP144994TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Physician Associates PLLC CurrentSince Jan 1, 2025 Accepting new patients
Ipa ER Group PLLC CurrentSince Nov 18, 2024 Accepting new patients
Texas Spine and Joint Hospital, LLC CurrentSince Feb 14, 2022 Accepting new patients

Locations

17101 Dallas Pkwy
Addison, TX 75001
Phone (214) 696-8033

6901 Snider Plz
Ste 130
Dallas, TX 75205
Phone (972) 381-6690

3150 Horizon Rd
Rockwall, TX 75032
Phone (469) 697-1000

2850 E Highway 114
Trophy Club, TX 76262
Phone (817) 837-4600

3414 Golden Rd
Tyler, TX 75701
Phone (903) 590-3050

1814 Roseland Blvd
Tyler, TX 75701
Phone (903) 525-3300

1814 Roseland Blvd
Ste 100
Tyler, TX 75701
Phone (214) 696-8033

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 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": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1053946368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 GOLDEN RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018336",
            "telephone_number": "903-939-7500",
            "fax_number": "903-939-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S DONNYBROOK AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014216",
            "telephone_number": "903-939-7500",
            "fax_number": "903-939-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIMERS",
        "first_name": "MARC",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP144994",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Flint",
            "affiliation": "N",
            "endpointDescription": "City",
            "address_1": "19902 County Road 172",
            "city": "Flint",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757626304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Flint",
            "affiliation": "N",
            "endpointDescription": "City",
            "address_1": "1814 Roseland Blvd",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757014234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.