Individual provider Active NPI

Erica Renee Preston, APRN-CNP

  • Family Nurse Practitioner
  • Clyde, TX
National Provider Identifier
1649864034
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1030957 Issued in TX
Practice address
1712 N Access Rd
Clyde, TX 79510-3352
Phone
(325) 893-4010
NPI assigned
Feb 25, 2021
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1030957 TX Primary

Addresses

Primary practice location

1712 N Access Rd
Clyde, TX 79510-3352

Mailing address

400 W Plummer St
Eastland, TX 76448-2627
Phone (254) 629-1744

Other practice location 1

400 W Plummer St
Eastland, TX 76448-2627
Phone (254) 629-1744

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
I20210511001314 TX Practitioner - Nurse Practitioner 8729497359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1712 N Access Rd
Clyde, TX 79510-3352
Phone (325) 893-4010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1030957TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shackelford County Community Resource Center CurrentSince Mar 27, 2023 Accepting new patients
Shackelford County Community Resource Center CurrentSince Mar 27, 2023 Accepting new patients
B & W Healthcare Associates PA CurrentSince Apr 28, 2021 Accepting new patients
B & W Clinic PA PastSince Mar 1, 2021 Accepting new patients
Shackelford County Community Resource Center Past Accepting new patients

Locations

725 Pate St
Albany, TX 76430
Phone (325) 762-2447

2802 W Walker St
Breckenridge, TX 76424
Phone (254) 559-7215

1712 N Access Rd
Clyde, TX 79510
Phone (325) 893-4010

301 S Main St
Cross Plains, TX 76443
Phone (254) 725-4311

400 W Plummer St
Eastland, TX 76448
Phone (254) 629-1744

217 Edwards
Merkel, TX 79536
Phone (325) 928-0014

Interoperability endpoints

  • Direct secure messaging: erica.preston.1@28291.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1649864034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W PLUMMER ST",
            "city": "EASTLAND",
            "state": "TX",
            "postal_code": "764482627",
            "telephone_number": "254-629-1744",
            "fax_number": "254-629-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 N ACCESS RD",
            "city": "CLYDE",
            "state": "TX",
            "postal_code": "795103352",
            "telephone_number": "325-893-4010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W Plummer St",
            "address_purpose": "LOCATION",
            "city": "Eastland",
            "state": "TX",
            "postal_code": "764482627",
            "country_code": "US",
            "telephone_number": "254-629-1744",
            "fax_number": "254-629-3904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "ERICA",
        "middle_name": "RENEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1030957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, TX

Sources for this page

Verify at the official NPI Registry.