Jennifer Kathryn Carreon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP142879 Issued in TX

Practice address

1411 E Amarillo Blvd
Amarillo, TX 79107-5555

Phone

(806) 351-7200

Fax

(806) 351-7274

NPI assigned

Aug 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jennifer Kathryn Ebeling Former name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwest Texas Wyatt Clinic, PLLCGroup PAC ID 8224255997, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Texas Hospital Hospital, Amarillo, TX, CCN 450209

Merit-based Incentive Payment System (MIPS)

Final score

99.52 of 100Reported as apm

Quality

87.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Northwest Texas Wyatt Clinic PLLC

  • Internal Medicine Physician
  • Amarillo, TX
  • NPI 1780008904
  Medicare reassignment Care Compare group NPD
• Northwest Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Amarillo, TX
  • NPI 1225449036

  Family

  Medicare reassignment NPD

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

• Northwest Texas Healthcare System Inc

  dba Northwest Texas Healthcare System

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1467442418
  Care Compare affiliation

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1760030100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75 STE 300",
            "address_2": "ATTN BILLING",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204587",
            "telephone_number": "806-351-7530",
            "fax_number": "806-351-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E AMARILLO BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791075555",
            "telephone_number": "806-351-7200",
            "fax_number": "806-351-7274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 Alexandria Ave",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791186197",
            "country_code": "US",
            "telephone_number": "806-420-9145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 SE 34TH AVENUE",
            "address_2": "Ste 1700",
            "address_purpose": "LOCATION",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791186732",
            "country_code": "US",
            "telephone_number": "806-351-7530",
            "fax_number": "806-351-7538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7200 SW 45th Ave",
            "address_2": "Unit 14",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791095084",
            "country_code": "US",
            "telephone_number": "806-680-1900",
            "fax_number": "806-513-6791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARREON",
        "first_name": "JENNIFER",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1A9386",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110488-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "1W2796",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "EBELING",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Londa G Carrasco, MD
• Norma A Carrasco, LPC
• Roberto Bejarano Carrasco, MD
• Sonya Selene Carrasco, LVN
• April Gale Carreon, TCM, CSW
• Carrie Jones, LPC-S, LLC
• Lindsey Nicole Carrier, FMP
• David Carrigan, HIS
• Alyssa Alexandra Carrillo, PT, DPT
• Arturo Carrillo, MD

• Family Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.