Individual provider Active NPI

Guy Wayne Nelson Jr.

  • Gerontology Nurse Practitioner
  • Webster, TX
National Provider Identifier
1306220009
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP128206 Issued in TX
Practice address
711 W Bay Area Blvd Ste 602
Webster, TX 77598-4042
Phone
(281) 332-2626
Fax
(281) 332-7272
NPI assigned
Jul 13, 2015
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP128206 TX Primary

Addresses

Primary practice location

711 W Bay Area Blvd Ste 602
Webster, TX 77598-4042

Mailing address

PO Box 8074
Pasadena, TX 77508-8074
Phone (281) 332-2626

Other identifiers 1

IdentifierTypeStateIssuer
349317307MedicaidTX

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
I20150901000335 TX Practitioner - Nurse Practitioner 5597071936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Medical Branch at Galveston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Armstrong Medical Group PLLCGroup PAC ID 5496013187, 30 clinicians

Practice addresses (Care Compare)

1307 W League City Pkwy
League City, TX 77573-6313
Phone (281) 332-2626

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP128206TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Hospital Medicine Associates, PA CurrentSince Jun 1, 2016 Accepting new patients

Locations

2620 Communications Pkwy
Plano, TX 75093
Phone (214) 501-4672

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

424 Tarpey Rd
#C
Texas City, TX 77591
Phone (409) 938-8431

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

Hospital & facility affiliations 2

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": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1306220009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8074",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775088074",
            "telephone_number": "281-332-2626",
            "fax_number": "281-332-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W BAY AREA BLVD STE 602",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984042",
            "telephone_number": "281-332-2626",
            "fax_number": "281-332-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GUY",
        "middle_name": "WAYNE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP128206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349317307",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.