Jerilyn Kay Town, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1151735 Issued in TX

Practice address

22325 Gosling Rd
Spring, TX 77389-4409

Phone

(281) 724-7980

Fax

(281) 547-7911

NPI assigned

Feb 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jerilyn Lopez Former name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Magnolia Management LLCGroup PAC ID 7810391984, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southern Magnolia Management LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spring, TX
  • NPI 1346866845

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1598529893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13914 PALATINE HL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782537005",
            "telephone_number": "330-727-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22325 GOSLING RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773894409",
            "telephone_number": "281-724-7980",
            "fax_number": "281-547-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWN",
        "first_name": "JERILYN",
        "middle_name": "KAY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1151735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERILYN",
            "last_name": "LOPEZ",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Maria Tovar, SLPA
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• Alexander Tran, PHARMD
• An Tran

• Psychiatric/Mental Health Nurse Practitioner in Spring, TX
• Providers in Spring, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.