The903Np

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

THE903NP

Practice address

2828 4TH St # 100
Longview, TX 75605-5718

Phone

(903) 903-0903

Fax

(903) 213-9045

NPI assigned

Sep 20, 2024

Organization subpart

No

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

Authorized official

Name

Charlsie Ferguson Gillcoat, APRN-BCNPI 1629246574

Title

Ceo / Nurse Practitioner

Phone

(903) 903-0903

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charlsie Ferguson Gillcoat, ACNP-BC

  • Primary Care Nurse Practitioner
  • Longview, TX
  • NPI 1629246574
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763856000000",
    "number": "1669299889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 4TH ST # 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055718",
            "telephone_number": "903-903-0903",
            "fax_number": "903-213-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 4TH ST # 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055718",
            "telephone_number": "903-903-0903",
            "fax_number": "903-213-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE903NP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2025-11-23",
        "certification_date": "2025-11-23",
        "status": "A",
        "authorized_official_last_name": "GILLCOAT",
        "authorized_official_first_name": "CHARLSIE",
        "authorized_official_middle_name": "FERGUSON",
        "authorized_official_title_or_position": "CEO / NURSE PRACTITIONER",
        "authorized_official_telephone_number": "903-903-0903",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Grace Clinic
• The Hope House Recovery Center, LLC
• The Oaks at Longview Operating
• The Pharmacy of Longview LLC (Medical Plaza Pharmacy)
• The Veta Lewis Behavioral Health Group
• Daniel R Theesfeld
• Therapy 4 US
• Kathleen Mary Thibodeaux Haslam, P.T.
• Krishna Thirumalai
• Angela Thomas

• Primary Care Nurse Practitioner in Longview, TX
• Providers in Longview, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.