Carol Jean Nelson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02477 Issued in TX

Practice address

100 Municipal Dr
Gun Barrel City, TX 75156-3702

Phone

(903) 713-1511

Fax

(903) 713-1519

NPI assigned

Oct 2, 2006

Last updated

Oct 24, 2019By the provider in NPPES

Sex

Female

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment
• Questcare Hospitalists PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1265441620
  Medicare reassignment
• Wise Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Decatur, TX
  • NPI 1366558264
  Medicare reassignment
• Affilion of Texas PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Corsicana, TX
  • NPI 1962696013
  NPD (past)
• Mesquite Physicians Group, PLLC

  • Emergency Medicine Physician
  • Mesquite, TX
  • NPI 1821397027
  NPD (past)
• Parker Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Weatherford, TX
  • NPI 1689923740

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1508959479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 NW CR 2171",
            "city": "BARRY",
            "state": "TX",
            "postal_code": "75102",
            "telephone_number": "903-229-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MUNICIPAL DR",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751563702",
            "telephone_number": "903-713-1511",
            "fax_number": "903-713-1519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "609 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "TX",
            "postal_code": "762343836",
            "country_code": "US",
            "telephone_number": "940-627-5921",
            "fax_number": "940-626-1351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "PA02477",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133367605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Middleton, APRN
• Midwife Jolene PLLC
• Emily Lauren Miller
• Miracles From Heaven Midwifery PLLC (The Birth Suite)
• Wilson Darell Murphy, MD
• Robert Dale Orr, RN
• Miguel Angel Padilla, DMD
• Luis Perez, O.D.
• Pines Boutique Services, LLC
• Podiatric Medical Partners of Texas, PA (Jonathan M Kletz, DPM PA)

• Physician Assistant in Gun Barrel City, TX
• Providers in Gun Barrel City, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.