Individual provider Active NPI

Fernando Adolfo Rios, FNP

  • Family Nurse Practitioner
  • Palestine, TX
National Provider Identifier
1356006787
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1168407 Issued in TX
Practice address
2900 TX-256 Loop
Palestine, TX 75801
Phone
(903) 731-1000
NPI assigned
Nov 1, 2021
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1168407 TX Primary

Addresses

Primary practice location

2900 TX-256 Loop
Palestine, TX 75801

Mailing address

4333 Gallion Cir
Tyler, TX 75708-7124
Phone (903) 780-4587

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
I20240917000583 TX Practitioner - Nurse Practitioner 2466993555 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1168407TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Family CurrentSince Oct 20, 2024 Accepting new patients

Locations

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

2900 S Loop 256
Palestine, TX 75801
Phone (903) 731-1021

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1356006787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 GALLION CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757087124",
            "telephone_number": "903-780-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 TX-256 LOOP",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "75801",
            "telephone_number": "903-731-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "FERNANDO",
        "middle_name": "ADOLFO",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-01",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1168407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.