Individual provider Active NPI

Jay Pribble, P.A.

  • Medical Physician Assistant
  • Arlington, TX
National Provider Identifier
1508097155
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA06256 Issued in TX
Practice address
3501 S Center Street
Arlington, TX 76014
Phone
(817) 468-1818
Fax
(817) 468-1818
NPI assigned
Jul 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA06256 TX Primary

Addresses

Primary practice location

3501 S Center Street
Arlington, TX 76014

Mailing address

3051 S Center St
Arlington, TX 76014-2023
Phone (817) 468-1818

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
I20141024002150 TX Practitioner - Physician Assistant 0840424560 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Cross Timbers ENT, PLLCGroup PAC ID 9234291840, 14 clinicians

Practice addresses (Care Compare)

400 W Arbrook Blvd
Suite 301
Arlington, TX 76014-3180
Phone (817) 261-3000

801 E Debbie LN
Mansfield, TX 76063-3179
Phone (817) 261-3000

Hospital & facility affiliations

  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlie Ruby D O P a Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jpribble@crosstent.emadirect.md

Organizations & group practices 4

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": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1508097155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 S CENTER ST",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142023",
            "telephone_number": "817-468-1818",
            "fax_number": "817-468-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S CENTER STREET",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76014",
            "telephone_number": "817-468-1818",
            "fax_number": "817-468-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIBBLE",
        "first_name": "JAY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2022-01-03",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.