Active NPI
Jason Eckols, FNP-C
- Family Nurse Practitioner
- San Antonio, TX
National Provider Identifier
1790220770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP132191
- Practice address
- 9111 Havelock St
San Antonio, TX 78254-2227 - Phone
- (210) 383-0809
- NPI assigned
- Dec 29, 2016
- Sex
- Male
- 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 | AP132191 | TX | Primary |
Addresses
Primary practice location
9111 Havelock St
San Antonio, TX 78254-2227
Mailing address
9111 Havelock St
San Antonio, TX 78254-2227
Phone (210) 383-0809
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 |
|---|---|---|---|---|
| I20231113003624 | TX | Order and Referring Only - Nurse Practitioner | 0941657944 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482969600000",
"number": "1790220770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9111 HAVELOCK ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782542227",
"telephone_number": "210-383-0809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9111 HAVELOCK ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782542227",
"telephone_number": "210-383-0809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKOLS",
"first_name": "JASON",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-29",
"last_updated": "2016-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP132191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.