Individual provider Active NPI

Mary E Andreasen, FNP

  • Family Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1073287652
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1034611 Issued in TX
Practice address
9176 White Oak Dr
Conroe, TX 77384-4626
Phone
(309) 261-0225
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1034611 TX Primary

Addresses

Primary practice location

9176 White Oak Dr
Conroe, TX 77384-4626

Mailing address

9176 White Oak Dr
Conroe, TX 77384-4626
Phone (309) 261-0225

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Conroe

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
I20230511000983 TX Practitioner - Nurse Practitioner 6204292501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Urgent Care PLLCGroup PAC ID 4880071679, 115 clinicians

Practice addresses (Care Compare)

10300 Louetta Rd
Suite 120
Houston, TX 77070-2121
Phone (346) 236-1082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1034611TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Urgent Care PLLC Single Specialty CurrentSince May 22, 2023 Accepting new patients

Locations

1505 E Winding Way Dr
Ste 112
Friendswood, TX 77546
Phone (281) 993-3860

10300 Louetta Rd
Ste 120
Houston, TX 77070
Phone (346) 236-1082

2510 Smith Ranch Rd
Ste 102
Pearland, TX 77584
Phone (346) 439-7481

19419 Gulf Fwy
Ste 3
Webster, TX 77598
Phone (281) 316-0885

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AACHCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1073287652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9176 WHITE OAK DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844626",
            "telephone_number": "309-261-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9176 WHITE OAK DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844626",
            "telephone_number": "309-261-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREASEN",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1034611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Conroe",
            "affiliation": "N",
            "address_1": "9176 White Oak Dr",
            "city": "Conroe",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773844626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.