Individual provider Active NPI

Elizabeth Grace Pullman, PA-C

  • Physician Assistant
  • Abilene, TX
National Provider Identifier
1932808714
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16606 Issued in TX
Practice address
1665 Antilley Rd Ste 200
Abilene, TX 79606-5271
Phone
(325) 695-4969
NPI assigned
Mar 1, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16606 TX Primary

Addresses

Primary practice location

1665 Antilley Rd Ste 200
Abilene, TX 79606-5271

Mailing address

125 Circle of Holly
Abilene, TX 79605-4917
Phone (817) 614-7217

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
I20230328000936 TX Practitioner - Physician Assistant 3274907514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1665 Antilley Rd
Abilene, TX 79606-5249

1665 Antilley Rd
Abilene, TX 79606-5264

1900 Pine St
Abilene, TX 79601-2432
Phone (325) 670-2000

1924 Pine St
Suite 402
Abilene, TX 79601-2452
Phone (325) 695-4969

950 N 19TH St
Suite 200
Abilene, TX 79601-2420
Phone (325) 695-4969

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA16606TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group West Texas, PLLC CurrentSince Mar 1, 2023 Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients

Locations

1665 Antilley Rd
Ste 170
Abilene, TX 79606
Phone (325) 437-8655

1665 Antilley Rd
Ste 200
Abilene, TX 79606
Phone (325) 793-5100

Interoperability endpoints

  • Direct secure messaging: elizabeth.pullman.1@23308.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1932808714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CIRCLE OF HOLLY",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054917",
            "telephone_number": "817-614-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 ANTILLEY RD STE 200",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065271",
            "telephone_number": "325-695-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLMAN",
        "first_name": "ELIZABETH",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.