Individual provider Active NPI

Gena Nelson, RN, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenville, TX
National Provider Identifier
1588790810
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP115347 Issued in TX
Practice address
4511 Stonewall St
Greenville, TX 75401-5951
Phone
(903) 454-7200
Fax
(903) 454-7204
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 688735 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP115347 TX Primary

Addresses

Primary practice location

4511 Stonewall St
Greenville, TX 75401-5951

Mailing address

4511 Stonewall St
Greenville, TX 75401-5951
Phone (903) 454-7200

Other identifiers 1

IdentifierTypeStateIssuer
688735OtherTXSTATE LICENSES

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
I20070919000494 TX Practitioner - Nurse Practitioner 1052405271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4511 Stonewall St
Greenville, TX 75401-5951
Phone (903) 454-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
688735TXMDPsychiatric/Mental Health Registered Nurse
AP115347TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gena Nelson RN, MSN, Pmhnp-BC PLLC Psychiatric/Mental Health CurrentSince Feb 28, 2012 Accepting new patients
Joel a. Holiner, MD PA Psychiatric/Mental Health PastSince Jul 1, 1998 Accepting new patients

Locations

4511 Stonewall St
Greenville, TX 75401
Phone (903) 454-7200

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1588790810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 STONEWALL ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015951",
            "telephone_number": "903-454-7200",
            "fax_number": "903-454-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 STONEWALL ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015951",
            "telephone_number": "903-454-7200",
            "fax_number": "903-454-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GENA",
        "credential": "RN, MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "688735",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP115347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSES",
            "identifier": "688735",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

Verify at the official NPI Registry.