Organization Active NPI

Zana Elliot Enterprises LLC

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1093025751
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
738885 Issued in TX
Legal business name
ZANA ELLIOT ENTERPRISES LLC
Practice address
12751 Westbrook Dr
Tyler, TX 75704
Phone
(903) 941-0786
Fax
(903) 881-5145
NPI assigned
Oct 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Zana Elliott, FNPNPI 1699973917
Title
Sole MBR
Phone
(903) 941-0786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 738885 TX Primary

Addresses

Primary practice location

12751 Westbrook Dr
Tyler, TX 75704

Mailing address

12751 Westbrook Dr
Tyler, TX 75704
Phone (903) 941-0786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110419000126 TX Part B Supplier - Clinic/Group Practice 1254515133 Receives reassigned benefits from 1 practitioner
Practice locations: Van, TX; Tyler, TX; Gladewater, TX

National Provider Directory

National Provider Directory

Locations

2200 W Upshur Ave
Gladewater, TX 75647
Phone (903) 845-2181

107 Stacy Dr
Whitehouse, TX 75791
Phone (718) 382-1313

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1093025751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12751 WESTBROOK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75704",
            "telephone_number": "903-941-0786",
            "fax_number": "903-881-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12751 WESTBROOK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75704",
            "telephone_number": "903-941-0786",
            "fax_number": "903-881-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZANA ELLIOT ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "ZANA",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "903-941-0786",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "738885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.