Individual provider Active NPI

Brenda S Iffland, FNP-C

  • Family Nurse Practitioner
  • Henderson, TX
National Provider Identifier
1861905523
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135282 Issued in TX
Practice address
321 Wilson St
Henderson, TX 75652-5957
Phone
(903) 392-0005
Fax
(903) 392-7772
NPI assigned
Nov 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135282 TX Primary

Addresses

Primary practice location

321 Wilson St
Henderson, TX 75652-5957

Mailing address

321 Wilson St
Henderson, TX 75652-5957
Phone (903) 392-0005

Other identifiers 1

IdentifierTypeStateIssuer
3842684-01MedicaidTX

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
I20180611000889 TX Practitioner - Nurse Practitioner 3870848120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 Wilson St
Henderson, TX 75652-5957
Phone (903) 392-0005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP135282TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care of Henderson, PLLC Family CurrentSince Mar 13, 2023 Accepting new patients
U.S.Walgama MD PA CurrentSince Oct 20, 2024 Accepting new patients

Locations

321 Wilson St
Henderson, TX 75652
Phone (903) 392-0005

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 1

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": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1861905523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525957",
            "telephone_number": "903-392-0005",
            "fax_number": "903-392-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525957",
            "telephone_number": "903-392-0005",
            "fax_number": "903-392-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFFLAND",
        "first_name": "BRENDA",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3842684-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TX

Sources for this page

Verify at the official NPI Registry.