Jennifer Eatherly, MSN, APRN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP131104 Issued in TX

Practice address

875 S Collegiate Dr
Paris, TX 75460-6305

Phone

(903) 785-8857

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Kidney Disease and Dialysis Associates, PAGroup PAC ID 2860656600, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paris Regional Medical Center Hospital, Paris, TX, CCN 450196
• Choctaw Memorial Hospital Hospital, Hugo, OK, CCN 370100
• Pushmataha Hospital Hospital, Antlers, OK, CCN 370083
• Titus Regional Medical Center Hospital, Mount Pleasant, TX, CCN 450080
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeatherly1262184@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.

• Kidney Disease and Dialysis Associates, PA

  • Nephrology Physician
  • Paris, TX
  • NPI 1427314608
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment NPD
• Healthtexas Provider Network

  • Cardiovascular Disease Physician
  • Idabel, OK
  • NPI 1316728702
  Medicare reassignment NPD
• Advanced Heart Care PA

  • Cardiovascular Disease Physician
  • Dallas, TX
  • NPI 1538197546
  Medicare reassignment
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Flower Mound, TX
  • NPI 1427054402
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Hopkins Health Alliance

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation
• Essent PRMC LP

  • General Acute Care Hospital
  • Paris, TX
  • NPI 1063411767
  Care Compare affiliation
• Titus County Hospital District

  • Multi-Specialty Clinic/Center
  • Mount Pleasant, TX
  • NPI 1063548881

  Hospital

  Care Compare affiliation
• Titus County Hospital District

  • General Acute Care Hospital
  • Mt Pleasant, TX
  • NPI 1174526529
  Care Compare affiliation
• Choctaw County City of Hugo Hospital Authority

  • Rural Acute Care Hospital
  • Hugo, OK
  • NPI 1881689289
  Care Compare affiliation
• Pushmataha County Hospital Authority

  • Rural Acute Care Hospital
  • Antlers, OK
  • NPI 1144212556
  Care Compare affiliation

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154771228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S COLLEGIATE DR",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754606305",
            "telephone_number": "903-785-8857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 E Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Idabel",
            "state": "OK",
            "postal_code": "747457345",
            "country_code": "US",
            "telephone_number": "580-208-2700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3550 NE Loop 286",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "TX",
            "postal_code": "754605004",
            "country_code": "US",
            "telephone_number": "903-785-0031",
            "fax_number": "903-784-6755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "113 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754822193",
            "country_code": "US",
            "telephone_number": "903-885-3059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EATHERLY",
        "first_name": "JENNIFER",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360754101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "200678330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Dunmon
• Jennifer Dawn Durham, LCSW
• John Derek Durham, MD
• Regina Diane Easlon, D.D.S.
• Kathleen Eastwood
• Peter Julius Edenhoffer, M.D.
• Elj Inc
• Elj Inc
• Katherine H Elliott, P.A.
• Michael Patrick Elliott, D.O.

• Family Nurse Practitioner in Paris, TX
• Providers in Paris, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.