Jack Roy Erwin, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

D4105 Issued in TX

Practice address

4740 NE Stallings Dr
Nacogdoches, TX 75965-1615

Phone

(936) 569-8246

Fax

(936) 564-3246

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Baylor College of Medicine, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Health and Human Services Commission

  • Clinical Neuropsychologist
  • Harlingen, TX
  • NPI 1356414692
  Medicare reassignment NPD
• Health and Human Services Commission

  • Psychiatric Hospital
  • Big Spring, TX
  • NPI 1881600682
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nacogdoches County Hospital District

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748
  Care Compare affiliation
• TH Healthcare, LTD

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568484152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651615",
            "telephone_number": "936-569-8246",
            "fax_number": "936-564-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651615",
            "telephone_number": "936-569-8246",
            "fax_number": "936-564-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERWIN",
        "first_name": "JACK",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "D4105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D4106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chris Elliott, MS, ATC, LAT, CES
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• Summerjoy Charity Gammage Enlow, DDS
• Jennifer P Enos
• Trent M. Erwin, D.D.S.
• David Espinosa, LCSW
• Ess of Nacogdoches LLC
• Etx Metabolic Syndrome Relief PLLC
• Chance Andrew Evans

• Otolaryngology Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.