Active NPI
Jacob Gise
- Family Nurse Practitioner
- Carrollton, TX
National Provider Identifier
1700437753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP143145
- Practice address
- 1428 W Hebron Pkwy
Carrollton, TX 75010-6345 - Phone
- (918) 671-5630
- NPI assigned
- Sep 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP143145 | TX | Primary |
Addresses
Primary practice location
1428 W Hebron Pkwy
Carrollton, TX 75010-6345
Mailing address
1000 Sonoma Dr
McKinney, TX 75072-3777
Phone (918) 671-5630
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191203002101 | TX | Order and Referring Only - Nurse Practitioner | 0345673422 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- jacob.gise@pfm1.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1700437753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 SONOMA DR",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750723777",
"telephone_number": "918-671-5630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1428 W HEBRON PKWY",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750106345",
"telephone_number": "918-671-5630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GISE",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-21",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP143145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.