Enola Marie Nelson, PA PHD

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01033 Issued in TX

Practice address

100 SE 4TH Street
Kerens, TX 75144-0033

Phone

(972) 449-3555

Fax

(972) 449-3344

NPI assigned

May 10, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant, Doctor of Philosophy

Practice roles

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.

• Grace & Mercy Health Clinic Inc.

  • Family Medicine Physician
  • Kerens, TX
  • NPI 1457482333

  TX

  Medicare reassignment
• All American Rehabilitation, Inc.

  • Physical Therapist
  • Dallas, TX
  • NPI 1922193267
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1376861799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SE 4TH STREET",
            "address_2": "BOX 33",
            "city": "KERENS",
            "state": "TX",
            "postal_code": "751440033",
            "telephone_number": "972-449-3555",
            "fax_number": "972-449-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SE 4TH STREET",
            "city": "KERENS",
            "state": "TX",
            "postal_code": "751440033",
            "telephone_number": "972-449-3555",
            "fax_number": "972-449-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ENOLA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mac'S Assisted Living
• April Denise Martin
• Rosanna I Mendoza
• Gloria Daveda Miller
• Belinda Harrell Moreland, O.T.R.
• Kimberly Joyce Nelson, NP
• Emly Roch, LMSW
• Amanda Nichole Sharp, COTA
• TH Speech Therapy

• All providers in Kerens, TX
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.