Individual provider Active NPI

Jeremy Allen Parker, PA-C

  • Medical Physician Assistant
  • Fredericksburg, TX
National Provider Identifier
1275762874
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA06383 Issued in TX
Practice address
1892 W US Hwy 290
Fredericksburg, TX 78624-6644
Phone
(830) 304-1666
Fax
(830) 304-1665
NPI assigned
Jul 6, 2009
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA06383 TX Primary

Addresses

Primary practice location

1892 W US Hwy 290
Fredericksburg, TX 78624-6644

Mailing address

1892 W US Hwy 290
Fredericksburg, TX 78624-6644
Phone (830) 304-1666

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
I20090909000335 TX Practitioner - Physician Assistant 6507911450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael C Speck MD PAGroup PAC ID 3072943653, 2 clinicians
Peterson Medical AssociatesGroup PAC ID 1355467887, 192 clinicians

Practice addresses (Care Compare)

1892 W US Hwy 290
Fredericksburg, TX 78624-6644

251 Cully Dr
Suite C
Kerrville, TX 78028-6084
Phone (830) 257-7533

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Medical Associates CurrentSince Feb 9, 2026 Accepting new patients
Urology Associates of Kerrville PastSince Feb 9, 2026 Accepting new patients

Locations

251 Cully Dr
Ste C
Kerrville, TX 78028
Phone (830) 257-7533

575 Hill Country Dr
Ste 202
Kerrville, TX 78028
Phone (830) 258-6237

Interoperability endpoints

  • Direct secure messaging: jeremyparker@gillespie.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1275762874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 W US HWY 290",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786246644",
            "telephone_number": "830-304-1666",
            "fax_number": "830-304-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 W US HWY 290",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786246644",
            "telephone_number": "830-304-1666",
            "fax_number": "830-304-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JEREMY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.