Individual provider Active NPI

Jessica Renee Tryon, FNP-C

  • Family Nurse Practitioner
  • Tolar, TX
National Provider Identifier
1376295220
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1068383 Issued in TX
Practice address
626 Billings Rd
Tolar, TX 76476-5423
Phone
(817) 776-6115
NPI assigned
Jan 21, 2022
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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 1068383 TX Primary

Addresses

Primary practice location

626 Billings Rd
Tolar, TX 76476-5423

Mailing address

626 Billings Rd
Tolar, TX 76476-5423
Phone (817) 776-6115

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
I20220602000280 TX Practitioner - Nurse Practitioner 0345628467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore ENTGroup PAC ID 2466412226, 3 clinicians

Practice addresses (Care Compare)

1305 Paluxy Rd
Suite a
Granbury, TX 76048-5641
Phone (817) 573-6673

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1068383TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore ENT CurrentSince Feb 1, 2022 Accepting new patients
Freedom Pain Care LLC PastSince Feb 1, 2022 Accepting new patients

Locations

1305 Paluxy Rd
Ste A
Granbury, TX 76048
Phone (817) 573-6673

925 Santa Fe Dr
Ste 112
Weatherford, TX 76086
Phone (817) 533-5233

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, 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": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1376295220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 BILLINGS RD",
            "city": "TOLAR",
            "state": "TX",
            "postal_code": "764765423",
            "telephone_number": "817-776-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 BILLINGS RD",
            "city": "TOLAR",
            "state": "TX",
            "postal_code": "764765423",
            "telephone_number": "817-776-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRYON",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1068383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolar, TX

Sources for this page

Verify at the official NPI Registry.