Jennifer Lynn Haterius, FNP
Individual provider Active NPI Nurse Practitioner · Floydada, TX
NPI 1649608985 · NPPES record last updated Dec 2, 2021
Key facts
- NPI
- 1649608985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP124606 (TX)
- Practice address
- 901 W Crockett St
Floydada, TX 79235-3609 - Phone
- (806) 402-4033
- Fax
- (806) 402-4036
- NPI assigned
- Oct 24, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 16
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Musc Community Physicians
Metro Infectious Disease Consultants LLC
Practice addresses (Care Compare)
169 Ashley Ave
Charleston, SC 29425-8905
4412 74TH St
Suite B100
Lubbock, TX 79424-2308
Phone (877) 448-3627
506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290
Hospital & facility affiliations
- Musc Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131122000511 | TX | Practitioner - Nurse Practitioner | 4981830916 | Reassigns benefits to 2 organizations |
| I20250317002430 | SC | Practitioner - Nurse Practitioner | 4981830916 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP124606 | TX | MD | Nurse Practitioner |
| 755706 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center Lubbock | Current |
Accepting new patients | |
| Musc Community Physicians | Current |
Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Current | Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Current |
Accepting new patients | |
| Metro Infectious Disease Consultants, LLC | Nurse Practitioner | Current |
Accepting new patients |
| Metro Infectious Disease Consultants LLC | Current |
Accepting new patients | |
| Musc Community Physicians | Current |
Accepting new patients |
Locations
901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201
901 McClintock Dr
Ste 201
Burr Ridge, IL 60527
Phone (630) 654-4201
506 North St
Bamberg, SC 29003
Phone (803) 245-6290
2003 E Lamar Blvd
Ste 100
Arlington, TX 76006
12319 N Mopac Expy
Ste 210
Austin, TX 78758
3030 E 29th St
Ste 106
Bryan, TX 77802
Phone (979) 731-8446
7515 Greenville Ave
Ste 505
Dallas, TX 75231
4312 Heritage Trace Pkwy
Ste 704
Fort Worth, TX 76244
Phone (817) 562-5905
602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898
4412 74th St
Ste B100
Lubbock, TX 79424
3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000
19016 Stone Oak Pkwy
Ste 140
San Antonio, TX 78258
Phone (210) 494-9109
8111 Cypresswood Dr
Ste 106
Spring, TX 77379
Phone (281) 370-9331
14875 Southwest Fwy
Sugar Land, TX 77478
Interoperability endpoints
- jhaterius526802@direct.musc.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 755706 | TX | |
| Nurse Practitioner | 363L00000X | AP124606 | TX | Yes |
Addresses
Primary practice location
901 W Crockett St
Floydada, TX 79235-3609
Mailing address
1806 Quincy St
Plainview, TX 79072-4206
Phone (806) 213-9560
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jennifer.haterius@direct.myteamcare.com |
Other providers in Floydada, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.