Individual provider Active NPI

Jennifer A Pearlman, NP

  • Family Nurse Practitioner
  • Colleyville, TX
National Provider Identifier
1700537974
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1056010 Issued in TX
Practice address
5207 Heritage Ave
Colleyville, TX 76034-5915
Phone
(817) 355-0000
NPI assigned
Jan 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 1056010 TX Primary

Addresses

Primary practice location

5207 Heritage Ave
Colleyville, TX 76034-5915

Mailing address

5207 Heritage Ave
Colleyville, TX 76034-5915
Phone (817) 355-0000

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
I20220202002694 TX Practitioner - Nurse Practitioner 8628461217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elis Medical CorporationGroup PAC ID 9133160088, 8 clinicians

Practice addresses (Care Compare)

5207 Heritage Ave
Colleyville, TX 76034-5915
Phone (817) 355-8000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elis Medical Corporation CurrentSince Dec 1, 2022 Accepting new patients

Locations

5207 Heritage Ave
Colleyville, TX 76034
Phone (817) 355-8000

901 Travis Ave
Ft Worth, TX 76104
Phone (817) 332-5585

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGAJDD
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: jpearlmanmh@emcdm-tx.direct.office.nextgen.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1700537974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5207 HERITAGE AVE",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345915",
            "telephone_number": "817-355-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 HERITAGE AVE",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345915",
            "telephone_number": "817-355-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARLMAN",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1056010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

Verify at the official NPI Registry.