John M Hettema, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

S3188 Issued in TX

Practice address

8441 Riverside Parkway
CB1, Suite 1100
Bryan, TX 77807

Phone

(979) 774-8200

Fax

(979) 776-6905

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Psychiatry

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Aandm University System Health Science CenterGroup PAC ID 8224008644, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Texas a&M University System Health Science Center

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1063699312
  Medicare reassignment Care Compare group NPD
• Texas a&M University System Health Science Center

  • Rural Health Clinic/Center
  • Navasota, TX
  • NPI 1558140004
  NPD

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1639259088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST",
            "address_2": "STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022623",
            "telephone_number": "979-436-0501",
            "fax_number": "979-776-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 RIVERSIDE PARKWAY",
            "address_2": "CB1, SUITE 1100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77807",
            "telephone_number": "979-774-8200",
            "fax_number": "979-776-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTEMA",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101056225",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S3188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heritage Maternity Services
• John Herman
• Macey Victoria Hernandez
• Robert A Herring, AU.D.
• Dorothy Hester, CRNA
• Taylor Hibbs, OD
• Chanel A Hicks, LPC
• Steven W Higginbotham, MD
• Donna M. Hilbig, LPC
• Kacy Lynn Hill

• Psychiatry Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.
• 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.