Individual provider Active NPI

Jamelia Eniece Abrams, DPM

  • Foot & Ankle Surgery Podiatrist
  • Grand Prairie, TX
National Provider Identifier
1447460910
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1848 Issued in TX
Practice address
2776 Bay Shore LN
Grand Prairie, TX 75054-7255
Phone
(817) 539-0588
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002169 MI
Foot & Ankle Surgery Podiatrist 213ES0103X 1848 TX Primary

Addresses

Primary practice location

2776 Bay Shore LN
Grand Prairie, TX 75054-7255

Mailing address

2776 Bay Shore LN
Grand Prairie, TX 75054-7255
Phone (817) 539-0588

Other identifiers 5

IdentifierTypeStateIssuer
193700508MedicaidTX
P01332015OtherTXRAILROAD MEDICARE
193700509MedicaidTX
193700504MedicaidTX
193700510MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901002169MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Mental Health & Mental Retardation Center Past Accepting new patients
Visiting Podiatry PLLC Past Accepting new patients
Visiting Podiatry PLLC PastSince Nov 12, 2012 Accepting new patients

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1447460910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 BAY SHORE LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750547255",
            "telephone_number": "817-539-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 BAY SHORE LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750547255",
            "telephone_number": "817-539-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "JAMELIA",
        "middle_name": "ENIECE",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002169",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193700508",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01332015",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193700509",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193700504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193700510",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.