NPIMap

Individual provider Active NPI

Jeremy Thomas Diver, PA-C

  • Medical Physician Assistant
  • Hurst, TX
National Provider Identifier
1679913354
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
6316 Precinct Line Rd
Hurst, TX 76054-2766
Phone
(817) 605-2525
NPI assigned
Jun 26, 2013
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TX Primary

Addresses

Primary practice location

6316 Precinct Line Rd
Hurst, TX 76054-2766

Mailing address

1512 Teasley LN
Denton, TX 76205-7282
Phone (940) 382-0980

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdiver851772@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140430000642 TX Practitioner - Physician Assistant 2860625761 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network CurrentSince Mar 24, 2014 Accepting new patients
Leeroy McCurley MD PA Current Accepting new patients
Healthtexas Provider Network CurrentSince Aug 9, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 9, 2021 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
North Texas Arrhythmia Associates PA Past Accepting new patients
Pilot Point Family Practice Management Inc. Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

3800 Gaylord Pkwy
Ste 910
Frisco, TX 75034
Phone (469) 800-4080

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

3121 S Carrier Pkwy
Grand Prairie, TX 75052
Phone (214) 649-4686

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: jeremy.diver@4668404203524.direct.elationemr.com
  • Direct secure messaging: jdiver851772@direct.sw.org

Organizations & group practices 10

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 1

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1679913354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 TEASLEY LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057282",
            "telephone_number": "940-382-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6316 PRECINCT LINE RD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542766",
            "telephone_number": "817-605-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVER",
        "first_name": "JEREMY",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdiver851772@direct.sw.org",
            "affiliation": "N",
            "address_1": "3800 Gaylord Pkwy Ste 910",
            "city": "Frisco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750349419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

Verify at the official NPI Registry.