Active NPI
Terri H. Bagwell, RN, FNP
- Family Nurse Practitioner
- Del Valle, TX
National Provider Identifier
1770734311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 233377
- Practice address
- 5301 Ross Rd
Del Valle, TX 78617-3288 - Phone
- (512) 386-3335
- Fax
- (512) 386-3333
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 233377 | TX | Primary |
Addresses
Primary practice location
5301 Ross Rd
Del Valle, TX 78617-3288
Mailing address
5301 Ross Rd
Del Valle, TX 78617-3288
Phone (512) 386-3335
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130213000484 | TX | Order and Referring Only - Nurse Practitioner | 5092969329 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 233377 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1770734311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 ROSS RD",
"city": "DEL VALLE",
"state": "TX",
"postal_code": "786173288",
"telephone_number": "512-386-3335",
"fax_number": "512-386-3333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 ROSS RD",
"city": "DEL VALLE",
"state": "TX",
"postal_code": "786173288",
"telephone_number": "512-386-3335",
"fax_number": "512-386-3333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGWELL",
"first_name": "TERRI",
"middle_name": "H.",
"credential": "RN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "233377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Del Valle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.