Individual provider Active NPI

Brandi Love, FNP

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1548521131
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
677855 Issued in TX
Practice address
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone
(903) 597-0351
NPI assigned
May 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 677855 TX Primary

Addresses

Primary practice location

1000 S Beckham Ave
Tyler, TX 75701-1908

Mailing address

901 Turtle Creek Dr
Tyler, TX 75701-1947
Phone (903) 596-3555

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
I20120730000577 TX Practitioner - Nurse Practitioner 8820254287 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
677855TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients

Locations

435 Doctor M Roper Pkwy N
Bullard, TX 75757
Phone (903) 360-6846

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

901 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 594-2418

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.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1548521131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011947",
            "telephone_number": "903-596-3555",
            "fax_number": "903-596-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "903-597-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "BRANDI",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "677855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.