Maria A. Provost, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M2618 Issued in TX

Practice address

2201 Clear Creek Rd
Killeen, TX 76549-4110

Phone

(254) 526-7523

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria A. Ferry Former name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mprovost210603@direct.sw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acute Care Surgery Texoma PLLC

  • Trauma Surgery Physician
  • Wichita Falls, TX
  • NPI 1841698453
  Medicare reassignment NPD
• Denton Colon and Rectal Surgery, P.a.

  • Colon & Rectal Surgery Physician
  • Denton, TX
  • NPI 1144266628
  NPD (past) Authorized official

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1114976693",
    "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",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494110",
            "telephone_number": "254-526-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "MARIA",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M2618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mprovost210603@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2201 Clear Creek Rd",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765494110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "FERRY",
            "middle_name": "A.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Professional Casemangement Services
• Professional Counseling Associates PLLC
• Professional Counseling Service
• Protherapy Solutions
• Susan M. Provost-Danner, OTR
• Psa Ambulatory Surgery Center of Killeen LLC
• Gary Pundt, D.D.S.
• Wayne Ervin Pundt, D.D.S
• Emily Purcell, M.A., SLP
• Quianna Jazmone Purham

• Surgery Physician in Killeen, TX
• Providers in Killeen, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.