Brandi Jo Foster
Individual provider Active NPI Family Nurse Practitioner · Canton, TX
NPI 1265095202 · NPPES record last updated Apr 16, 2019
Key facts
- NPI
- 1265095202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP141112 (TX)
- Practice address
- 4437 Etheride Circle
Canton, TX 75103 - Phone
- (903) 288-5301
- NPI assigned
- Apr 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cedar Creek Clinic LLC
Practice addresses (Care Compare)
2418 W Main St
Gun Barrel City, TX 75156-3638
Phone (903) 713-2000
Hospital & facility affiliations
- Ut Health East Texas Athens Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200520002222 | TX | Practitioner - Nurse Practitioner | 3779914007 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut East Texas Urgent Care Centers, PLLC | Current |
Accepting new patients | |
| Cedar Creek Clinic, LLC | Current |
Accepting new patients |
Locations
301 E State Highway 243
Ste 121
Canton, TX 75103
Phone (903) 567-4692
2418 W Main St
Gun Barrel City, TX 75156
Phone (903) 713-2000
Interoperability endpoints
- bfoster876302@ahs.direct-ci.com
- https://fhir4.healow.com/fhir/r4/GAGGCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP141112 | TX | Yes |
Addresses
Primary practice location
4437 Etheride Circle
Canton, TX 75103
Mailing address
4437 Etheride Circle
Canton, TX 75103
Phone (903) 288-5301
Other providers in Canton, TX
- Leslea Evans
- Fannin County Hospital Authority
- Adam Franklin Fischer
- Foot Clinic of East Texas, PC
- Forever Kids Pediatric Clinic
- Kaitlin Franklin
- Nicholas J Galloway II
- Gold Star Assisted Living
- Virginia Yolanda Gonzalez
- Deanna Lindsley Goode
All providers in Canton, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.