Organization Active NPI

Generational Health Innovations

  • Community Health Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1912887415
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
Legal business name
GENERATIONAL HEALTH INNOVATIONS
Practice address
844 S Fleishel Ave
Tyler, TX 75701-2042
Phone
(954) 557-2775
NPI assigned
Sep 4, 2025
Last updated
Oct 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Jennifer A Blake
Title
Ceo
Phone
(954) 557-2775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X Primary

Addresses

Primary practice location

844 S Fleishel Ave
Tyler, TX 75701-2042

Mailing address

PO Box 6994
Tyler, TX 75711-6994
Phone (954) 557-2775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251201002997 TX Part B Supplier - Clinic/Group Practice 5799278511 Receives reassigned benefits from 1 practitioner
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1912887415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6994",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116994",
            "telephone_number": "954-557-2775",
            "fax_number": "903-805-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012042",
            "telephone_number": "954-557-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONAL HEALTH INNOVATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-557-2775"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.