Individual provider Active NPI

Jessica Diann Brittain, ACAG-NP

  • Acute Care Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1760040349
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
804657 Issued in TX
Practice address
2501 Lakeview Dr
Amarillo, TX 79109-1531
Phone
(806) 358-9400
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 804657 TX Primary

Addresses

Primary practice location

2501 Lakeview Dr
Amarillo, TX 79109-1531

Mailing address

2501 Lakeview Dr
Amarillo, TX 79109-1531
Phone (806) 350-8277

Other identifiers 1

IdentifierTypeStateIssuer
804657OtherTXTEXAS BON

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
I20190807003602 TX Practitioner - Nurse Practitioner 5395072789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FMC LTC Aco LLCGroup PAC ID 3678013729, 22 clinicians

Practice addresses (Care Compare)

2501 Lakeview Dr
Amarillo, TX 79109-1531
Phone (806) 350-8277

Hospital & facility affiliations

  • Pampa Regional Medical Center Hospital, Pampa, TX, CCN 451398
  • Golden Plains Community Hospital Hospital, Borger, TX, CCN 451369

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
804657TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FMC LTC Aco LLC CurrentSince Aug 1, 2024 Accepting new patients
FMC Long-Term Care, P.a. CurrentSince Dec 30, 2019 Accepting new patients
Wichita Falls Kidney Clinic PA Past Accepting new patients
Austin Nephrology Associates, PA Past Accepting new patients

Locations

1616 S Kentucky St
Ste B100
Amarillo, TX 79102
Phone (806) 355-8900

2501 Lakeview Dr
Amarillo, TX 79109
Phone (806) 350-7325

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1760040349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 LAKEVIEW DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091531",
            "telephone_number": "806-350-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 LAKEVIEW DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091531",
            "telephone_number": "806-358-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTAIN",
        "first_name": "JESSICA",
        "middle_name": "DIANN",
        "credential": "ACAG-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "804657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BON",
            "identifier": "804657",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.