Individual provider Active NPI

Rhonda F Mathis, ACNP

  • Acute Care Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1245534379
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
687595 Issued in TX
Practice address
912 S Fleishel Ave
Tyler, TX 75701-2018
Phone
(903) 592-6901
Fax
(903) 595-2571
NPI assigned
Jan 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 687595 TX Primary

Addresses

Primary practice location

912 S Fleishel Ave
Tyler, TX 75701-2018

Mailing address

912 S Fleishel Ave
Tyler, TX 75701-2018
Phone (903) 592-6901

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
I20111214000929 TX Practitioner - Nurse Practitioner 0840465100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
687595TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Jun 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jun 1, 2019 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

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

912 S Fleishel Ave
Tyler, TX 75701
Phone 90359269011811

Interoperability endpoints

  • Direct secure messaging: rmathis354914@ahs.direct-ci.com

Organizations & group practices 2

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 1

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": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1245534379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012018",
            "telephone_number": "903-592-6901",
            "fax_number": "903-595-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012018",
            "telephone_number": "903-592-6901",
            "fax_number": "903-595-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "RHONDA",
        "middle_name": "F",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "687595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.