Individual provider Active NPI

Sally Jean Flores, APRN-CNP

  • Adult Health Nurse Practitioner
  • Bullard, TX
National Provider Identifier
1114898889
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1056293 Issued in TX
Practice address
10798 County Road 152 W
Bullard, TX 75757-8504
Phone
(559) 281-0778
NPI assigned
Sep 16, 2025
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1056293 TX Primary

Addresses

Primary practice location

10798 County Road 152 W
Bullard, TX 75757-8504

Mailing address

10798 County Road 152 W
Bullard, TX 75757-8504
Phone (559) 281-0778

Other names 1

  • Sally Jean Storer Former name

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
I20251010002931 TX Practitioner - Nurse Practitioner 1052696507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

13027 State Hwy 155 S
Tyler, TX 75703-6560
Phone (903) 839-1000

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1056293TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pallicare, Inc CurrentSince Sep 26, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sally.flores.1@26850.direct.athenahealth.com

Organizations & group practices 2

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": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1114898889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10798 COUNTY ROAD 152 W",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757578504",
            "telephone_number": "559-281-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10798 COUNTY ROAD 152 W",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757578504",
            "telephone_number": "559-281-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "SALLY",
        "middle_name": "JEAN",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1056293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "STORER",
            "middle_name": "JEAN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bullard, TX

Sources for this page

Verify at the official NPI Registry.