Individual provider Active NPI

Ellen Stice Nauert, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1245857424
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36485 Issued in TX
Practice address
7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone
(507) 315-2823
NPI assigned
Jul 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36485 TX Primary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D14404 MN
Dentist 122300000X 0401418274 VA

Addresses

Primary practice location

7703 Floyd Curl Dr
San Antonio, TX 78229-3901

Mailing address

17206 Sable LNDG
San Antonio, TX 78232-4122
Phone (512) 627-8503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628003720 VA Order and Referring Only - DentistPractitioner - Dentist 6901265628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14404MNMDDentist
36485TXMDDentist
0401418274VAMDDentist

Interoperability endpoints

  • Direct secure messaging: enauert56877@direct.utmsa.com

NPI Registry JSON

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1245857424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17206 SABLE LNDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324122",
            "telephone_number": "512-627-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "507-315-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUERT",
        "first_name": "ELLEN",
        "middle_name": "STICE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36485",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14404",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418274",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.