Individual provider Active NPI

Janquilyn Driver Merida, DNP

  • Nurse Practitioner
  • Corsicana, TX
National Provider Identifier
1740304427
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
654264 Issued in TX
Practice address
618 N Main St
Corsicana, TX 75110-3028
Phone
(903) 872-2151
Fax
(903) 872-0126
NPI assigned
Mar 19, 2007
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 654264 TX Primary
Family Nurse Practitioner 363LF0000X F0402043 TX

Addresses

Primary practice location

618 N Main St
Corsicana, TX 75110-3028

Mailing address

PO Box 518
Corsicana, TX 75151-0518
Phone (903) 872-2151

Other identifiers 4

IdentifierTypeStateIssuer
00Y226OtherTXMEDICARE GROUP
DG9311OtherTXRAILROAD MEDICARE GROUP
005691305MedicaidTX
P0046391OtherTXRAILROAD MEDICARE

Other names 1

  • Janquilyn I Driver Former name

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
I20050708000662 TX Practitioner - Nurse Practitioner 2062448384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Navarro County Ambulatory Care AssociationGroup PAC ID 2466827035, 2 clinicians

Practice addresses (Care Compare)

618 N Main St
Corsicana, TX 75110-3028
Phone (903) 874-6731

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F0402043TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Navarro County Ambulatory Care Association CurrentSince Nov 24, 2022 Accepting new patients
Corsicana-Navarro County Public Health District CurrentSince Sep 27, 2023 Accepting new patients
Medical and Surgical Associates of Corsicana PLLC Nurse Practitioner Past Accepting new patients

Locations

618 N Main St
Corsicana, TX 75110
Phone (903) 874-6711

Interoperability endpoints

  • Direct secure messaging: janquilyn.merida.1@29197.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1740304427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751510518",
            "telephone_number": "903-872-2151",
            "fax_number": "903-872-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N MAIN ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103028",
            "telephone_number": "903-872-2151",
            "fax_number": "903-872-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERIDA",
        "first_name": "JANQUILYN",
        "middle_name": "DRIVER",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "654264",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F0402043",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "00Y226",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DG9311",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005691305",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P0046391",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANQUILYN",
            "last_name": "DRIVER",
            "middle_name": "I",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.