NPIMap

Individual provider Active NPI

John E Nix, MD

  • Family Medicine Physician
  • Texarkana, TX
National Provider Identifier
1972598837
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K7362 Issued in TX
Practice address
2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone
(903) 791-9120
Fax
(903) 791-9132
NPI assigned
Sep 16, 2005
Last updated
Dec 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K7362 TX Primary

Addresses

Primary practice location

2101 Galleria Oaks Dr
Texarkana, TX 75503-4625

Mailing address

2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone (903) 614-5950

Other identifiers 2

IdentifierTypeStateIssuer
4995690001OtherTXCIGNA GOVERNMENT SERVICES
042151304MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040326000476 TX Practitioner - Family Practice 3375435126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medical Group of TexarkanaGroup PAC ID 3870485626, 12 clinicians

Practice addresses (Care Compare)

2101 Galleria Oaks Dr
Texarkana, TX 75503-4625
Phone (903) 791-9120

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Group of Texarkana Family Medicine CurrentSince Feb 1, 2004 Accepting new patients
Intrepid of Louisiana Inc PastSince Jul 20, 2011 Accepting new patients

Locations

2101 Galleria Oaks Dr
Texarkana, TX 75503
Phone (903) 791-9120

2602 Saint Michael Dr
Fl 4
Texarkana, TX 75503
Phone (903) 614-5370

5212 W 7th St
Wake Village, TX 75501
Phone (903) 791-9120

Interoperability endpoints

  • Direct secure messaging: johnnix@fmgt.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1972598837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034625",
            "telephone_number": "903-614-5950",
            "fax_number": "903-614-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034625",
            "telephone_number": "903-791-9120",
            "fax_number": "903-791-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K7362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "4995690001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042151304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.