Individual provider Active NPI

Jennifer Lynn Eaddy, FNP-C

  • Primary Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1144825563
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1027651 Issued in TX
Practice address
115 Gallery Cir Ste 201
San Antonio, TX 78258-3492
Phone
(210) 904-3090
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1027651 TX Primary

Addresses

Primary practice location

115 Gallery Cir Ste 201
San Antonio, TX 78258-3492

Mailing address

115 Gallery Cir Ste 201
San Antonio, TX 78258-3492
Phone (210) 904-3090

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
I20210831003129 TX Practitioner - Nurse Practitioner 1254737133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1125 Towhee TRL
New Braunfels, TX 78132-3442
Phone (737) 279-5005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1027651TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
US Multi-Specialty Group CurrentSince Aug 16, 2021 Accepting new patients
Patient Centrix PLLC CurrentSince Apr 20, 2024 Accepting new patients

Locations

14008 Shadowglen Blvd
Manor, TX 78653
Phone (512) 445-4800

115 Gallery Cir
Ste 201
San Antonio, TX 78258
Phone (210) 904-3090

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1144825563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 GALLERY CIR STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583492",
            "telephone_number": "210-904-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 GALLERY CIR STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583492",
            "telephone_number": "210-904-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADDY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1027651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.