Individual provider Active NPI

Nina Nicole Totanes, AGACNP

  • Nurse Practitioner
  • Live Oak, TX
National Provider Identifier
1356942148
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1019522 Issued in TX
Practice address
12412 Judson Rd
Live Oak, TX 78233-3255
Phone
(210) 640-5235
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1019522 TX
Acute Care Nurse Practitioner 363LA2100X 869298 TX
Nurse Practitioner 363L00000X 1019522 TX Primary

Addresses

Primary practice location

12412 Judson Rd
Live Oak, TX 78233-3255

Mailing address

708 Clearbrook Ave
Schertz, TX 78108-3436
Phone (210) 464-5105

Other practice location 1

12709 Toepperwein Rd Ste 203
Live Oak, TX 78233-3259
Phone (210) 640-5235

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NINA.TOTANES@hca7.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1019522TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Synergenx Physician Services PLLC Past Accepting new patients
Southwest Texas Two Medical Group, PLLC Past Accepting new patients

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1356942148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CLEARBROOK AVE",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781083436",
            "telephone_number": "210-464-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333255",
            "telephone_number": "210-640-5235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12709 Toepperwein Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Live Oak",
            "state": "TX",
            "postal_code": "782333259",
            "country_code": "US",
            "telephone_number": "210-640-5235",
            "fax_number": "210-967-0383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOTANES",
        "first_name": "NINA",
        "middle_name": "NICOLE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2022-01-04",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1019522",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "869298",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1019522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NINA.TOTANES@hca7.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12709 Toepperwein Rd Ste 203",
            "city": "Live Oak",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782333259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.