Individual provider Active NPI

Trevor Poire, FNP-C

  • Family Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1477028637
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139022 Issued in TX
Practice address
4510 Bell St
Amarillo, TX 79109-5714
Phone
(806) 212-4835
Fax
(806) 212-0900
NPI assigned
Oct 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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 AP139022 TX Primary

Addresses

Primary practice location

4510 Bell St
Amarillo, TX 79109-5714

Mailing address

PO Box 840026
Dallas, TX 75284-0026
Phone (806) 212-5079

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
I20181029000928 TX Practitioner - Nurse Practitioner 3375896921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians

Practice addresses (Care Compare)

1000 S Coulter St
Suite 100
Amarillo, TX 79106-1781
Phone (806) 212-4701

1751 Wallace Blvd
Amarillo, TX 79106-1711
Phone (806) 359-4673

4510 Bell St
Amarillo, TX 79109-5714
Phone (806) 212-4835

Hospital & facility affiliations

  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bsa Physicians Group Inc CurrentSince Oct 5, 2018 Accepting new patients
Bsa Physicians Group Inc CurrentSince Oct 5, 2018 Accepting new patients

Locations

4510 Bell St
Amarillo, TX 79109
Phone (806) 212-4835

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

Interoperability endpoints

  • Direct secure messaging: tpoire22120@ahs.direct-ci.com

Organizations & group practices 2

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.

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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1477028637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840026",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840026",
            "telephone_number": "806-212-5079",
            "fax_number": "806-212-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 BELL ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095714",
            "telephone_number": "806-212-4835",
            "fax_number": "806-212-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRE",
        "first_name": "TREVOR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.