Individual provider Active NPI

Jeffery Nash, APRN

  • Gerontology Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1770049397
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP140372 Issued in TX
Practice address
#4 Valley View Circle
Texarkana, TX 75503
Phone
(903) 293-7806
NPI assigned
Feb 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP140372 TX Primary

Addresses

Primary practice location

#4 Valley View Circle
Texarkana, TX 75503

Mailing address

#4 Valley View Circle
Texarkana, TX 75503
Phone (903) 293-7806

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
I20190507002531 TX Practitioner - Nurse Practitioner 4981946266 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Appello Health and Wellness Clinic LLCGroup PAC ID 3971043290, 76 clinicians
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

2223 Grant St
Malvern, AR 72104-4700
Phone (501) 337-9031

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

Hospital & facility affiliations

  • Mays Home Health of Paris TX LLC Home health agency, Paris, TX, CCN 457586
  • Heritage Home Health Home health agency, Texarkana, TX, CCN 458337
  • Kelton Home Health Care Home health agency, Atlanta, TX, CCN 673148
  • Encompass Health Home Health Home health agency, Texarkana, AR, CCN 047168
  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Southwest Regional Medical Center LLC Hospital, Hope, AR, CCN 041335

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP140372TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icarepro of Texas, PA CurrentSince Aug 19, 2022 Accepting new patients
Icare Pro of Texas Aco Billing Professional Association CurrentSince Jun 1, 2023 Accepting new patients

Locations

4114 McKnight Rd
Ste C
Texarkana, TX 75503
Phone (501) 492-0099

4140 McKnight Rd
Ste D
Texarkana, TX 75503

Interoperability endpoints

  • Direct secure messaging: jeffery.nash.1@26850.direct.athenahealth.com

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 7

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": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1770049397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#4 VALLEY VIEW CIRCLE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-293-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#4 VALLEY VIEW CIRCLE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-293-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "JEFFERY",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP140372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.