Individual provider Active NPI

Jena Mann, FNP-C

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1366857757
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP125874 Issued in TX
Practice address
364 Richland West Cir
Waco, TX 76712-7919
Phone
(254) 537-0911
NPI assigned
Jun 25, 2014
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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 AP125874 TX Primary

Addresses

Primary practice location

364 Richland West Cir
Waco, TX 76712-7919

Mailing address

364 Richland West Cir
Waco, TX 76712-7919

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
I20140811000422 TX Practitioner - Nurse Practitioner 1759508039 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waco Gastroenterology AssociatesGroup PAC ID 5991795056, 15 clinicians

Practice addresses (Care Compare)

364 Richland W Cir
Suite a
Waco, TX 76712-7919
Phone (254) 537-0911

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 30, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Dec 30, 2019 Accepting new patients
Waco Gastroenterology Associates CurrentSince Jun 30, 2014 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Medhealth PastSince Jun 30, 2014 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

3410 Worth St
Ste 860
Dallas, TX 75246

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

364 Richland West Cir
Waco, TX 76712
Phone (254) 537-0306

364 Richland West Cir
#A
Waco, TX 76712
Phone (254) 537-0911

Interoperability endpoints

  • Direct secure messaging: jmann66188@direct.sw.org

Organizations & group practices 5

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1366857757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 RICHLAND WEST CIR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 RICHLAND WEST CIR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127919",
            "telephone_number": "254-537-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JENA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.