Individual provider Active NPI

John Phillip Frasure, PA-C

  • Physician Assistant
  • Johnson City, TX
National Provider Identifier
1093787400
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05105 Issued in TX
Practice address
208 Haley Rd
Johnson City, TX 78636-4617
Phone
(830) 868-4033
NPI assigned
Feb 2, 2006
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05105 TX Primary
Physician Assistant 363A00000X 1049273 NU

Addresses

Primary practice location

208 Haley Rd
Johnson City, TX 78636-4617

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 1

IdentifierTypeStateIssuer
PA05105OtherTXSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfrasure69381@direct.sw.org Direct

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
I20110520000041 TX Practitioner - Physician Assistant 3971789298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1300 E Polk St
Baylor Scott and White Clinic Burnet
Burnet, TX 78611-2136
Phone (512) 715-6400

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W Hwy 71
Marble Falls Professional Services Group
Marble Falls, TX 78654-8602
Phone (830) 201-8000

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05105TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Hospital - Marble Falls CurrentSince Oct 17, 2019 Accepting new patients
Scott & White Clinic CurrentSince Jan 1, 2016 Accepting new patients
Scott & White Hospital - Marble Falls CurrentSince Oct 17, 2019 Accepting new patients
River City Emergency Physicians, PLLC Past Accepting new patients
Radiation Oncology of San Antonio, PA Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 E Jackson St
Burnet, TX 78611
Phone (512) 756-7510

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

208 Haley Rd
Johnson City, TX 78636
Phone (210) 454-7404

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

810 W Highway 71
Marble Falls, TX 78654
Phone (830) 201-7100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

546 N Kegley Rd
Temple, TX 76502
Phone (254) 215-0900

Interoperability endpoints

  • Direct secure messaging: jfrasure69381@direct.sw.org

Organizations & group practices 7

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 5

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1093787400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 HALEY RD",
            "city": "JOHNSON CITY",
            "state": "TX",
            "postal_code": "786364617",
            "telephone_number": "830-868-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASURE",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05105",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1049273",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA05105",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfrasure69381@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "208 Haley Rd",
            "city": "Johnson City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786364617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnson City, TX

Sources for this page

Verify at the official NPI Registry.