Individual provider Active NPI

Floyd Edsil Jernigan, M.D.

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1891755088
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J0022 Issued in TX
Practice address
7700 Fish Pond Rd
Waco, TX 76710-1031
Phone
(254) 761-4444
Fax
(254) 761-4441
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J0022 TX Primary

Addresses

Primary practice location

7700 Fish Pond Rd
Waco, TX 76710-1031

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

556 N Loop 340
Bellmead, TX 76705-2572
Phone (254) 412-5700

Other identifiers 1

IdentifierTypeStateIssuer
84191KOtherTXBLUE SHIELD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address fjernigan14159@direct.sw.org Direct
Direct Messaging Address fjernigan14159@direct.sw.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329000943 TX Practitioner - Family Practice 2961538939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

7700 Fish Pond Rd
Waco, TX 76710-1031
Phone (254) 761-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Family Medicine CurrentSince Jan 1, 1998 Accepting new patients
Scott & White Clinic Family Medicine CurrentSince Jan 1, 1998 Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

7700 Fish Pond Rd
Waco, TX 76710
Phone (254) 741-4444

556 N Loop 340
Waco, TX 76705
Phone (254) 313-5400

Interoperability endpoints

  • Direct secure messaging: fjernigan14159@direct.sw.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1891755088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FISH POND RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767101031",
            "telephone_number": "254-761-4444",
            "fax_number": "254-761-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "556 N Loop 340",
            "address_purpose": "LOCATION",
            "city": "Bellmead",
            "state": "TX",
            "postal_code": "767052572",
            "country_code": "US",
            "telephone_number": "254-412-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "FLOYD",
        "middle_name": "EDSIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J0022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "84191K",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fjernigan14159@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "556 N Loop 340",
            "city": "Bellmead",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767052572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fjernigan14159@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7700 Fish Pond Rd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767101031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.