Jellirica Peters

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP136929 Issued in TX

Practice address

3001 Bee Caves Rd Ste 220
Rollingwood, TX 78746-5590

Phone

(512) 777-2591

NPI assigned

Mar 7, 2018

Last updated

Mar 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jellirica Tan Former name

Medicare fee-for-service enrollment

Enrolled in TX, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Options for Southern OregonGroup PAC ID 0941202006, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Options for Southern Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grants Pass, OR
  • NPI 1558366492
  Medicare reassignment Care Compare group NPD
• Kotel Atx PLLC

  dba Heading Health

  • Adult Mental Health Clinic/Center
  • Austin, TX
  • NPI 1568055192
  Medicare reassignment NPD
• Nueces County Mental Health & Mental Retardation Community Ctr

  dba Nueces Center for Mental Health and Intellectual Disabilities

  • Psychiatry Physician
  • Corpus Christi, TX
  • NPI 1255357828

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Texas Behavioral Health PLLC

  • Psychiatry Physician
  • Pearland, TX
  • NPI 1881044337
  Medicare reassignment NPD
• Coos County Oregon

  dba Coos Health & Wellness

  • Clinic/Center
  • Coos Bay, OR
  • NPI 1811981053
  Medicare reassignment NPD
• Nueces County Mental Health & Mental Retardation Community Ctr.

  dba Nueces Center for Mental Health and Intellectual Disabilities

  • Mental Health Counselor
  • Corpus Christi, TX
  • NPI 1467463042
  NPD
• United Psychiatry Institute, LLC

  • Child & Adolescent Psychiatry Physician
  • Houston, TX
  • NPI 1689913279
  NPD
• Options for Southern Oregon

  • Primary Care Clinic/Center
  • Grants Pass, OR
  • NPI 1952708422
  NPD

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1962904722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BEE CAVES RD STE 220",
            "city": "ROLLINGWOOD",
            "state": "TX",
            "postal_code": "787465590",
            "telephone_number": "512-229-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BEE CAVES RD STE 220",
            "city": "ROLLINGWOOD",
            "state": "TX",
            "postal_code": "787465590",
            "telephone_number": "512-777-2591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12234 Shadow Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775847330",
            "country_code": "US",
            "telephone_number": "713-289-5325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 Biscayne Blvd # 1013",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331375013",
            "country_code": "US",
            "telephone_number": "855-306-7786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JELLIRICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP136929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JELLIRICA",
            "last_name": "TAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emmanuel John Lee, M. D.
• Lejla Medic, APRN-CNP
• Wayne Nguyen, PSYD
• Marisa Ievans O'Connor
• Kruti Patel, PH.D.
• Jonathan William Prokop
• Richard Family Chiropractic, PA (Gonstead Chiropractic & Wellness ATX)
• Al Dean Richard, D.C.
• Jacob Rodriguez, LCSW
• Sara Hammond Wellness LLC

• Psychiatric/Mental Health Nurse Practitioner in Rollingwood, TX
• Providers in Rollingwood, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.