Individual provider Active NPI

Adam Justice, APRN, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1225703036
Registry record updated Aug 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1047251 Issued in TX
Practice address
1133 Medical Dr
Tyler, TX 75701-2130
Phone
(903) 595-5486
Fax
(903) 595-5128
NPI assigned
Aug 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 220881 LA
Acute Care Nurse Practitioner 363LA2100X 1047251 TX Primary

Addresses

Primary practice location

1133 Medical Dr
Tyler, TX 75701-2130

Mailing address

1133 Medical Dr
Tyler, TX 75701-2130
Phone (903) 595-5486

Other practice location 1

612 S Fleishel Ave
Tyler, TX 75701-2012
Phone (903) 510-1193

Other practice location 2

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 593-8441

Other practice location 3

1453 E Bert Koun Loop
Shreveport, LA 71105-6800
Phone (318) 681-4500

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
I20221128000809 TX Practitioner - Nurse Practitioner 1557752169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Nephrology Associates PAGroup PAC ID 6901862242, 27 clinicians

Practice addresses (Care Compare)

1133 Medical Dr
Tyler, TX 75701-2130
Phone (903) 595-5486

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1047251TXMDNurse Practitioner
220881LAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Nephrology Associates, P.a. CurrentSince Jan 4, 2023 Accepting new patients

Locations

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1133 Medical Dr
Tyler, TX 75701
Phone 9035955486173

Interoperability endpoints

  • Direct secure messaging: ajustice837238@ahs.direct-ci.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ajustice47689@direct.acumenmd.com

Organizations & group practices 1

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 4

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1225703036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 S Fleishel Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012012",
            "country_code": "US",
            "telephone_number": "903-510-1193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 S Beckham Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757011908",
            "country_code": "US",
            "telephone_number": "903-593-8441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1453 E Bert Koun Loop",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711056800",
            "country_code": "US",
            "telephone_number": "318-681-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "ADAM",
        "credential": "APRN, ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-12",
        "last_updated": "2026-08-02",
        "certification_date": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "220881",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1047251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.