Individual provider Active NPI

Tonia Jerrick

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Sugar Land, TX
National Provider Identifier
1417418112
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
V9918 Issued in TX
Practice address
17500 W Grand Pkwy S
Sugar Land, TX 77479-2562
Phone
(281) 725-5000
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X V9918 TX Primary
Pediatrics Physician 208000000X 4301507119 MI

Addresses

Primary practice location

17500 W Grand Pkwy S
Sugar Land, TX 77479-2562

Mailing address

17500 W Grand Pkwy S
Sugar Land, TX 77479-2562

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2000

Other practice location 2

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 985-4632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230623000268 MI Practitioner - Pediatric Medicine 3274912282 Reassigns benefits to 1 organization
I20251229003672 TX Practitioner - Pediatric Medicine 3274912282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 Park Ave NE
Unit 408
Atlanta, GA 30326-3440

4100 International PLZ
Fort Worth, TX 76109-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301507119MIMDPediatrics Physician
V9918TXMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Jun 2, 2023 Accepting new patients
Memorial Hermann Hospital Based Physician Group CurrentSince Oct 13, 2025 Accepting new patients
Lakeland Medical Practices CurrentSince Jun 2, 2023 Accepting new patients

Locations

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

22430 Grand Corner Dr
#C1100
Katy, TX 77494

2555 Gulf Fwy S
#C1100
League City, TX 77573

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1417418112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17500 W GRAND PKWY S",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 W GRAND PKWY S",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792562",
            "telephone_number": "281-725-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1234 Napier Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "269-985-4632",
            "fax_number": "269-985-4523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERRICK",
        "first_name": "TONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "V9918",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301507119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.