Individual provider Active NPI

Jerry Wayne Ary, ACNP

  • Acute Care Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1326398702
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
717985 Issued in TX
Practice address
3514 21St St
Lubbock, TX 79410-1210
Phone
(806) 725-1801
Fax
(806) 723-7535
NPI assigned
Sep 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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 717985 TX Primary

Addresses

Primary practice location

3514 21St St
Lubbock, TX 79410-1210

Mailing address

3420 22ND PL
Lubbock, TX 79410-1314
Phone (806) 725-5844

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
I20130424000756 TX Practitioner - Nurse Practitioner 5092951723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Pulmonary and Sleep Disorders Associates P aGroup PAC ID 2365580438, 27 clinicians

Practice addresses (Care Compare)

10837 Katy Fwy
Suite 250
Houston, TX 77079-2205
Phone (713) 464-9099

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
717985TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Pulmonary and Sleep Disorders Associates P a CurrentSince Mar 9, 2018 Accepting new patients
Covenant Medical Group Past Accepting new patients

Locations

10837 Katy Fwy
Ste 250
Houston, TX 77079
Phone (713) 464-8099

18300 Katy Fwy
Ste 615
Houston, TX 77094
Phone (713) 464-8099

701 S Fry Rd
Ste 225
Katy, TX 77450
Phone (713) 464-8099

Interoperability endpoints

  • Direct secure messaging: jary82438@directhoustonmethodist.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1326398702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101314",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 21ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101210",
            "telephone_number": "806-725-1801",
            "fax_number": "806-723-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARY",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "717985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.