Individual provider Active NPI

Gina M Nickels-Nelson, FNP

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1376526921
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1007313 Issued in TX
Practice address
1000 E 5TH St Ste 200
Tyler, TX 75701-3313
Phone
(903) 747-9600
Fax
(903) 747-9601
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 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 1007313 TX Primary

Addresses

Primary practice location

1000 E 5TH St Ste 200
Tyler, TX 75701-3313

Mailing address

1000 E 5TH St Ste 200
Tyler, TX 75701-3313
Phone (903) 747-9600

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
I20220811001878 TX Practitioner - Nurse Practitioner 5294630786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 E 5TH St
Suite 100
Tyler, TX 75701-3307
Phone (903) 590-5000

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Aug 1, 2022 Accepting new patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2026 Accepting new patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2026 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Aug 1, 2022 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

3310 Patriot Dr
Tyler, TX 75701
Phone (903) 877-8925

1000 E 5th St
Ste 200
Tyler, TX 75701
Phone (903) 594-2666

1000 E 5th St
Ste 100
Tyler, TX 75701
Phone (903) 590-5000

Interoperability endpoints

  • Direct secure messaging: gnickelsnelson781951@ahs.direct-ci.com

Organizations & group practices 4

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1376526921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST STE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013313",
            "telephone_number": "903-747-9600",
            "fax_number": "903-747-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST STE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013313",
            "telephone_number": "903-747-9600",
            "fax_number": "903-747-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELS-NELSON",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1007313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.