Elizabeth Brooke Main, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1059117 Issued in TX

Practice address

804 W Main St
Hallsville, TX 75650-5102

Phone

(903) 374-5465

NPI assigned

Oct 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut East Texas Urgent Care Centers, PLLCGroup PAC ID 7517385388, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ut East Texas Urgent Care Centers, PLLC

  • Urgent Care Clinic/Center
  • Canton, TX
  • NPI 1356974281
  Medicare reassignment Care Compare group NPD
• DCS Medical PA

  • Urgent Care Clinic/Center
  • Princeton, TX
  • NPI 1285082768
  Medicare reassignment
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD (past)
• Phynet, Inc.

  • Health Service Clinic/Center
  • Gladewater, TX
  • NPI 1912174111
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769817600000",
    "number": "1407510399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4279 OLD HIGHWAY 135 S",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756627879",
            "telephone_number": "903-374-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 W MAIN ST",
            "city": "HALLSVILLE",
            "state": "TX",
            "postal_code": "756505102",
            "telephone_number": "903-374-5465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3753 Earl Campbell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757011273",
            "country_code": "US",
            "telephone_number": "903-747-9552",
            "fax_number": "903-747-9553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 N Kilgore St",
            "address_purpose": "LOCATION",
            "city": "Kilgore",
            "state": "TX",
            "postal_code": "756626054",
            "country_code": "US",
            "telephone_number": "903-522-4199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAIN",
        "first_name": "ELIZABETH",
        "middle_name": "BROOKE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2026-01-31",
        "certification_date": "2026-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "F09210916",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1059117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall & Gengel PLLC
• Emily Dalenda Lansdale
• Nikamiah Lewis
• Krystin Nicole Liles, RN
• Lone Star Medical Therapy PLLC
• Merge Medical
• Gale Minchew, PH.D.
• Jeffrey Minchew, LPC
• Abby Grace Modisette, COTA
• Taryn Nolte

• Nurse Practitioner in Hallsville, TX
• Providers in Hallsville, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2026; 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.