Individual provider Active NPI

Emily Sundeen, FNP

  • Primary Care Nurse Practitioner
  • Greenville, TX
National Provider Identifier
1962803304
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP121278 Issued in TX
Practice address
4215 Joe Ramsey Blvd E
Greenville, TX 75401-7852
Phone
(903) 408-1946
NPI assigned
Sep 4, 2014
Last updated
Sep 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP121278 TX Primary

Addresses

Primary practice location

4215 Joe Ramsey Blvd E
Greenville, TX 75401-7852

Mailing address

3346 County Road 3115
Greenville, TX 75402-8884
Phone (903) 513-6584

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
I20180703001260 TX Practitioner - Nurse Practitioner 1355645078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4311 Wesley St
Greenville, TX 75401-5639
Phone (903) 455-5958

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP121278TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Service Agency, Inc. CurrentSince Feb 17, 2022 Accepting new patients
Community Health Service Agency, Inc. Current Accepting new patients
Community Health Service Agency, Inc. CurrentSince Feb 17, 2022 Accepting new patients
Community Health Service Agency, Inc. Past Accepting new patients

Locations

91 W Side Sq
Cooper, TX 75432
Phone (903) 395-0586

4311 Wesley St
Greenville, TX 75401
Phone (903) 455-5958

Interoperability endpoints

  • Direct secure messaging: emily.sundeen.p4@direct.chsa.nextgenshare.com

Organizations & group practices 4

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1962803304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3346 COUNTY ROAD 3115",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754028884",
            "telephone_number": "903-513-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 JOE RAMSEY BLVD E",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017852",
            "telephone_number": "903-408-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDEEN",
        "first_name": "EMILY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP121278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

Verify at the official NPI Registry.