Individual provider Active NPI

Christy Rachel Yetter I, MPAS, PA-C

  • Physician Assistant
  • Ennis, TX
National Provider Identifier
1710003926
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2203 W Lampasas St
Suite 205
Ennis, TX 75119-5644
Phone
(972) 875-6200
NPI assigned
Mar 21, 2007
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2203 W Lampasas St
Suite 205
Ennis, TX 75119-5644

Mailing address

710 Cody Rd
Ennis, TX 75119-8830
Phone (972) 878-6227

Other practice location 1

1305 N Highway 77
Waxahachie, TX 75165-5117
Phone (972) 937-1203

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
I20140509000488 TX Practitioner - Physician Assistant 7315170768 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

104 S Main St
Keller, TX 76248-5003
Phone (214) 295-9385

345 N Hwy 67
Cedar Hill, TX 75104-2134
Phone (972) 956-5300

377 W Campbell Rd
Suite 100
Richardson, TX 75080-3695
Phone (469) 232-2945

8450 E Fwy
Fort Worth, TX 76120-4413
Phone (817) 459-2005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care Texas, P.a. CurrentSince May 1, 2024 Accepting new patients
Medexpress Urgent Care Texas, P.a. CurrentSince May 1, 2024 Accepting new patients

Locations

5001 S Hulen St
Fort Worth, TX 76132
Phone (817) 361-1928

22915 Morton Ranch Rd
Katy, TX 77449
Phone (281) 574-0124

1305 N Highway 77
Waxahachie, TX 75165
Phone (972) 937-1203

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1710003926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CODY RD",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751198830",
            "telephone_number": "972-878-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 W LAMPASAS ST",
            "address_2": "SUITE 205",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751195644",
            "telephone_number": "972-875-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 N Highway 77",
            "address_purpose": "LOCATION",
            "city": "Waxahachie",
            "state": "TX",
            "postal_code": "751655117",
            "country_code": "US",
            "telephone_number": "972-937-1203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YETTER",
        "first_name": "CHRISTY",
        "middle_name": "RACHEL",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ennis, TX

Sources for this page

Verify at the official NPI Registry.