Individual provider Active NPI

Justin Lee Wren, FNP-C

  • Family Nurse Practitioner
  • Granbury, TX
National Provider Identifier
1396639886
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1000392 Issued in TX
Practice address
805 Hill Blvd Unit 102
Granbury, TX 76048-1482
Phone
(682) 205-3690
NPI assigned
Jun 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 1000392 TX Primary

Addresses

Primary practice location

805 Hill Blvd Unit 102
Granbury, TX 76048-1482

Mailing address

PO Box 14950
Oklahoma City, OK 73113-0950
Phone (682) 205-3690

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
I20250623003286 TX Practitioner - Nurse Practitioner 9032621339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

805 Hill Blvd
Unit 102
Granbury, TX 76048-1482
Phone (682) 205-3690

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DCS Medical PA CurrentSince Jun 16, 2025 Accepting new patients
DCS Medical PA CurrentSince Jun 16, 2025 Accepting new patients
DCS Medical PA Past Accepting new patients

Locations

1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

805 Hill Blvd
Unit 102
Granbury, TX 76048
Phone (817) 346-5920

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 1

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": "1749254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1396639886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14950",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731130950",
            "telephone_number": "682-205-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 HILL BLVD UNIT 102",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481482",
            "telephone_number": "682-205-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-07",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1000392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.