Individual provider Active NPI

Terry Emerson, NP

  • Neonatal Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1073792107
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP104642 Issued in TX
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 414-9800
Fax
(806) 356-4673
NPI assigned
Oct 25, 2007
Last updated
May 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 252210 TX
Neonatal Nurse Practitioner 363LN0000X 252210 TX
Neonatal Nurse Practitioner 363LN0000X AP104642 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 Wallace Blvd
Amarillo, TX 79106-1708
Phone (806) 414-9800

Other identifiers 7

IdentifierTypeStateIssuer
187731802MedicaidTX
187731801MedicaidTX
187731803MedicaidTX
187731804MedicaidTX
1877MedicaidTX
36258270MedicaidNM
200079990AMedicaidOK

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
I20060228000140 TX Practitioner - Nurse Practitioner 7416963541 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP104642TXMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo CurrentSince May 31, 2010 Accepting new patients
Texas Tech University Health Sciences Center CurrentSince May 31, 2010 Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Past Accepting new patients

Locations

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

1400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5585

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1073792107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9800",
            "fax_number": "806-356-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "TERRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "252210",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "252210",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "AP104642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187731802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187731801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187731803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187731804",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1877",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36258270",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200079990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.