Individual provider Active NPI

William H Lovett III, PA

  • Medical Physician Assistant
  • Bryan, TX
National Provider Identifier
1811061930
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 04673 Issued in TX
Practice address
2206 E Villa Maria Rd
Bryan, TX 77802-2547
Phone
(979) 776-4600
Fax
(979) 776-8749
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 04673 TX Primary

Addresses

Primary practice location

2206 E Villa Maria Rd
Bryan, TX 77802-2547

Mailing address

2206 E Villa Maria Rd
Bryan, TX 77802-2547
Phone (979) 776-4600

Other identifiers 1

IdentifierTypeStateIssuer
PA04673OtherTXLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address centraltexasgi@directaddress.net

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
I20070222000199 TX Practitioner - Physician Assistant 3971605981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Texas Digestive Disease Association, PAGroup PAC ID 4284618711, 9 clinicians

Practice addresses (Care Compare)

2206 E Villa Maria Rd
Bryan, TX 77802-2547
Phone (979) 776-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 04673TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Midwest Emergency Physicians PA Past Accepting new patients

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1811061930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-776-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-776-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVETT",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA 04673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA04673",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "centraltexasgi@directaddress.net",
            "affiliation": "N",
            "address_1": "2206 E Villa Maria Rd",
            "city": "Bryan",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778022547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.