Linus Scott Medley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP142679 Issued in TX

Practice address

1711 S Henderson Blvd Ste 300
Kilgore, TX 75662-3563

Phone

(903) 988-0605

Fax

(903) 988-9804

NPI assigned

Jan 24, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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, 2010

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

Interoperability endpoints

• Direct secure messaging: lmedley914352@ahs.direct-ci.com

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
• QV Urgent Care TX PLLC

  • Family Medicine Physician
  • Henderson, TX
  • NPI 1568098887
  Medicare reassignment NPD
• QV Urgent Care TX PLLC

  • Rural Health Clinic/Center
  • Madisonville, TX
  • NPI 1669198347
  NPD
• Phynet, Inc.

  • Health Service Clinic/Center
  • Gladewater, TX
  • NPI 1912174111
  NPD (past)
• Total Point - Desoto LLC

  • Family Medicine Physician
  • Lindale, TX
  • NPI 1104590330
  NPD (past)
• Acs Emergency Services of Mississippi Professional Association

  • Emergency Medicine Physician
  • Cleveland, MS
  • NPI 1396996997
  NPD (past)
• Broad Avenue Urgent Care

  • Urgent Care Clinic/Center
  • Gulfport, MS
  • NPI 1164727285
  NPD (past)

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1497050306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 TECHNOLOGY CTR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052697",
            "telephone_number": "903-247-0484",
            "fax_number": "903-247-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S HENDERSON BLVD STE 300",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623563",
            "telephone_number": "903-988-0605",
            "fax_number": "903-988-9804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15200 Community Rd",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395033085",
            "country_code": "US",
            "telephone_number": "228-575-7000 x7120",
            "fax_number": "228-575-7114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "LINUS",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R790626",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412015601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP142679",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Ann Majors, OPTICIAN
• Debra McAvoy
• Clifton McKinney
• Kevin L. McNabb
• Michael McShan, MD
• Meno Group, PLLC
• Michael B Gardner PC
• Michael W. McShan, M.D., P.a.
• Mark Douglas Miller, MD
• Lori Jean Moon, LCDC

• Family Nurse Practitioner in Kilgore, TX
• Providers in Kilgore, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.