Individual provider Active NPI

Jennifer Lynn Pepper, MD

  • Emergency Medicine Physician
  • Waco, TX
National Provider Identifier
1245334853
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J8710 Issued in TX
Practice address
6901 Medical Parkway
Waco, TX 76712
Phone
(254) 751-4146
Fax
(254) 751-4283
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TXBJ8710 TX
Emergency Medicine Physician 207P00000X J8710 TX Primary

Addresses

Primary practice location

6901 Medical Parkway
Waco, TX 76712

Mailing address

PO Box 2589
Waco, TX 76702-2589
Phone (254) 751-4146

Other identifiers 2

IdentifierTypeStateIssuer
136880513MedicaidTX
8S0954OtherTXBCBS

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
I20130621000054 TX Practitioner - Emergency Medicine 7911964721 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TXBJ8710TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physicians-II, P.a. CurrentSince Apr 1, 2017 Accepting new patients
Legacy Urgent Care, PA CurrentSince Apr 1, 2023 Accepting new patients
Frisco Emergency Medicine Associates, PA Emergency Medicine Past Accepting new patients

Locations

330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777

9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020

2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277

8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277

211 W Frontier Pkwy
Prosper, TX 75078
Phone (469) 868-9100

900 Austin Ave
Ste 1001
Waco, TX 76701
Phone (254) 224-8808

9110 Jordan Ln
Ste 100
Woodway, TX 76712
Phone (254) 399-0740

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1245334853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2589",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767022589",
            "telephone_number": "254-751-4146",
            "fax_number": "254-751-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 MEDICAL PARKWAY",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76712",
            "telephone_number": "254-751-4146",
            "fax_number": "254-751-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "TXBJ8710",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J8710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136880513",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S0954",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.