Jon Braden Debault, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1016837 Issued in TX

Practice address

8836 Mars Dr
Hewitt, TX 76643-3195

Phone

(254) 420-5500

NPI assigned

Oct 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Comprehensive Injury Treatment Services PLLC

  • General Practice Physician
  • Temple, TX
  • NPI 1811325954
  Medicare reassignment NPD
• Curana Health Medical Group LLC

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1255640678
  Medicare reassignment NPD
• West Coast Wound and Skin Care Inc

  • Surgery Physician
  • Burbank, CA
  • NPI 1437675980

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1225636996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 LEGACY LN APT 925",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765131840",
            "telephone_number": "512-429-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 MARS DR",
            "city": "HEWITT",
            "state": "TX",
            "postal_code": "766433195",
            "telephone_number": "254-420-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBAULT",
        "first_name": "JON",
        "middle_name": "BRADEN",
        "name_prefix": "Mr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1016837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Cooney, DDS
• Monte B Cooper, DDS
• David Q. Moore, L.L.C.
• Kristen Tilton Davis, M.S., CCC-SLP
• Tonya Nichole Davis, BCBA-D
• DJF Enterprise, PLLC
• Nancy Dominguez, EDD, MED, LPC
• Parker James Donner, PH.D.
• Elite Wellness Waco LLC
• Mark Anthony Ervi, M.S.S.W., LCSW

• Family Nurse Practitioner in Hewitt, TX
• Providers in Hewitt, 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 Oct 14, 2020; 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.