Individual provider Active NPI

Zana Elliott, FNP

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1699973917
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
738885 Issued in TX
Practice address
967 Pruitt PL
Tyler, TX 75703-1153
Phone
(903) 266-1599
Fax
(903) 266-1589
NPI assigned
Jul 8, 2007
Last updated
Dec 31, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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 738885 TX Primary

Addresses

Primary practice location

967 Pruitt PL
Tyler, TX 75703-1153

Mailing address

12751 Westbrook Dr
Tyler, TX 75704-2458
Phone (903) 266-1599

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
I20091028000535 TX Practitioner - Nurse Practitioner 3779509708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2200 W Upshur Ave
Gladewater, TX 75647-4328
Phone (903) 845-2181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
738885TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Zana Elliot Enterprises LLC Family CurrentSince Nov 11, 2010 Accepting new patients
Jordan Physician Associates, Inc. Past Accepting new patients
Steve E Rowley DO PA Past Accepting new patients
DRS. Berg and Wen, L.L.C. Past Accepting new patients
Jordan Physician Associates, Inc. Family Past Accepting new patients

Locations

2200 W Upshur Ave
Gladewater, TX 75647
Phone (903) 845-2181

5403 Plantation Dr
Tyler, TX 75703
Phone (903) 534-4955

967 Pruitt Pl
Tyler, TX 75703
Phone (903) 266-1599

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.

NPI Registry JSON

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

{
    "created_epoch": "1183852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1699973917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12751 WESTBROOK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757042458",
            "telephone_number": "903-266-1599",
            "fax_number": "903-266-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 PRUITT PL",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031153",
            "telephone_number": "903-266-1599",
            "fax_number": "903-266-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ZANA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-08",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "738885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.