Alicia Rose Adkison, FNP
Individual provider Active NPI Family Nurse Practitioner · Tyler, TX
NPI 1104287929 · NPPES record last updated Jun 22, 2022
Key facts
- NPI
- 1104287929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP130259 (TX)
- Practice address
- 1720 South Beckham
Tyler, TX 75701 - Phone
- (903) 595-5101
- NPI assigned
- Mar 8, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160517000377 | TX | Practitioner - Nurse Practitioner | 2466741368 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP130259 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Health Science Center at Tyler-Facilty-Physician | Current |
Accepting new patients | |
| University of Texas Health Science Center at Tyler-Facility-Physician | Current |
Accepting new patients | |
| East Texas Infectious Disease Consultants, PLLC | Current |
Accepting new patients |
Locations
102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201
935 S Baxter Ave
Ste 103
Tyler, TX 75701
Phone (903) 592-4473
11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451
Interoperability endpoints
- aadkison355085@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP130259 | TX | Yes |
Addresses
Primary practice location
1720 South Beckham
Tyler, TX 75701
Mailing address
1720 South Beckham
Tyler, TX 75701
Phone (903) 595-5101
Other practice location 1
11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-7200
Other providers in Tyler, TX
- Bianca Simone Reed Adetutu
- Deborah Adeyemo
- Pratik Adhikari
- Adjust Your Health Chiropractic
- Matthew W. Adkins
- Brandon Chase Adkison
- Rebecca Adricula
- Adult Counseling and Resources, PLLC
- Advanced Eyecare
- Advanced Health Center PLLC
All providers in Tyler, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.