Individual provider Active NPI

Elise Jeanne Meeks, FNP-C

  • Family Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1922668045
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN270340 Issued in GA
Practice address
690 S Loop 336 W
Conroe, TX 77304-3319
Phone
(936) 828-3962
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN270340 GA Primary
Registered Nurse 163W00000X 662914 TX
Registered Nurse 163W00000X RN270340 GA
Family Nurse Practitioner 363LF0000X 1142371 TX

Addresses

Primary practice location

690 S Loop 336 W
Conroe, TX 77304-3319

Mailing address

690 S Loop 336 W
Conroe, TX 77304-3319
Phone (936) 828-3962

Other names 1

  • Elise Jeanne Coles Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200410001325 GA Practitioner - Family Practice 4385073428 Reassigns benefits to 1 organization
I20250301000168 TX Practitioner - Nurse Practitioner 4385073428 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN270340GAMDRegistered Nurse
662914TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc CurrentSince Mar 3, 2020 Accepting new patients
Lakeside Gastroenterology and Liver Specialists, PLLC CurrentSince Dec 22, 2024 Accepting new patients

Locations

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

3217 4th St
Brunswick, GA 31520
Phone (912) 264-9650

2040 Dan Proctor Dr
Ste 210
Saint Marys, GA 31558
Phone (866) 403-3376

690 S Loop 336 W
Ste 215
Conroe, TX 77304
Phone (936) 228-9980

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAEABA

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": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1922668045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043319",
            "telephone_number": "936-828-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043319",
            "telephone_number": "936-828-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKS",
        "first_name": "ELISE",
        "middle_name": "JEANNE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN270340",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "662914",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN270340",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1142371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "COLES",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.