NPIMap

Individual provider Active NPI

Mary Hazel Brantley, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Vernon, TX
National Provider Identifier
1376052860
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135219 Issued in TX
Practice address
4301 College Dr RM 400
Vernon, TX 76384-3166
Phone
(940) 553-2802
Fax
(940) 553-2893
NPI assigned
Sep 27, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 AP135219 TX Primary

Addresses

Primary practice location

4301 College Dr RM 400
Vernon, TX 76384-3166

Mailing address

4301 College Dr RM 400
Vernon, TX 76384-3166
Phone (940) 553-2802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171115000691 TX Practitioner - Nurse Practitioner 5092071670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

920 Hillcest Dr
Vernon, TX 76384-3132
Phone (940) 552-9351

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wilbarger County Hospital District CurrentSince Nov 8, 2017 Accepting new patients
Wilbarger County Hospital District CurrentSince Nov 8, 2017 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

4301 College Dr
Vernon, TX 76384
Phone (940) 552-9351

4301 College Dr
Rm 200
Vernon, TX 76384
Phone (940) 552-2620

4301 College Dr
Rm 400
Vernon, TX 76384
Phone (940) 357-1266

920 Hillcrest Dr
Vernon, TX 76384
Phone (940) 552-9351

Organizations & group practices 3

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 8

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376052860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 COLLEGE DR RM 400",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843166",
            "telephone_number": "940-553-2802",
            "fax_number": "940-553-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 COLLEGE DR RM 400",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843166",
            "telephone_number": "940-553-2802",
            "fax_number": "940-553-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "MARY",
        "middle_name": "HAZEL",
        "credential": "MSN, RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, TX

Sources for this page

Verify at the official NPI Registry.