Individual provider Active NPI

Destanee Thomae, APRN FNP

  • Nurse Practitioner
  • Abilene, TX
National Provider Identifier
1710792791
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1190103 Issued in TX
Practice address
4438 S Clack St
Abilene, TX 79606-3634
Phone
(325) 704-4470
NPI assigned
Feb 7, 2025
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1190103 TX Primary

Addresses

Primary practice location

4438 S Clack St
Abilene, TX 79606-3634

Mailing address

1687 County Road 173
Winters, TX 79567-6609
Phone (940) 886-6628

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
I20251218002066 TX Practitioner - Nurse Practitioner 2163917097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Urgent Care LLCGroup PAC ID 1658632872, 14 clinicians

Practice addresses (Care Compare)

2424 Quaker Ave
Lubbock, TX 79410-1834
Phone (806) 902-8635

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1190103TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Urgent Care LLC CurrentSince Oct 11, 2025 Accepting new patients
West Texas Urgent Care LLC CurrentSince Oct 11, 2025 Accepting new patients
West Texas Urgent Care LLC Past Accepting new patients

Locations

4438 S Clack St
Abilene, TX 79606
Phone (325) 704-4470

4438 S Clack St
Ste 200
Abilene, TX 79606
Phone (325) 704-4470

2424 Quaker Ave
Lubbock, TX 79410
Phone (806) 283-5844

Organizations & group practices 3

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": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1710792791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 COUNTY ROAD 173",
            "city": "WINTERS",
            "state": "TX",
            "postal_code": "795676609",
            "telephone_number": "940-886-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796063634",
            "telephone_number": "325-704-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAE",
        "first_name": "DESTANEE",
        "credential": "APRN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1190103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.