Individual provider Active NPI

Eleanor Elizabeth Avery, MD

  • Sleep Medicine (Internal Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1235169574
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
M9821 Issued in TX
Practice address
7400 Merton Minter St
San Antonio, TX 78229
Phone
(210) 616-8385
Fax
(210) 616-8383
NPI assigned
Jul 3, 2006
Last updated
Jul 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X M9821 TX Primary

Addresses

Primary practice location

7400 Merton Minter St
San Antonio, TX 78229

Mailing address

7400 Merton Minter St
San Antonio, TX 78229-4404
Phone (210) 616-8385

Other practice location 1

2200 Bergquist Dr Ste 1
ATTN: Credentials (CMC)
Lackland A F B, TX 78236-9908
Phone (210) 292-6707

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120625000700 TX Order and Referring Only - NeurologyPractitioner - Neurology 2668637687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9821TXMDSleep Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1235169574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-616-8385",
            "fax_number": "210-616-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-616-8385",
            "fax_number": "210-616-8383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Bergquist Dr Ste 1",
            "address_2": "ATTN: Credentials (CMC)",
            "address_purpose": "LOCATION",
            "city": "Lackland A F B",
            "state": "TX",
            "postal_code": "782369908",
            "country_code": "US",
            "telephone_number": "210-292-6707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVERY",
        "first_name": "ELEANOR",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TX",
            "license": "M9821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.