Individual provider Active NPI

Deanna Ellen Bishop, FNP-BC

  • Family Nurse Practitioner
  • Nacogdoches, TX
National Provider Identifier
1972982866
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP128114 Issued in TX
Practice address
1309 S. University Dr
East Texas Community Health Services, Inc.
Nacogdoches, TX 75961
Phone
(936) 560-5413
NPI assigned
May 25, 2015
Last updated
Oct 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP128114 TX Primary

Addresses

Primary practice location

1309 S. University Dr
East Texas Community Health Services, Inc.
Nacogdoches, TX 75961

Mailing address

PO BX 632040
Nacogdoches, TX 75963
Phone (936) 560-5413

Other names 1

  • Mrs. Deanna Ellen Perry Former name

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
I20220303001846 TX Practitioner - Nurse Practitioner 2163450313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP128114TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2022 Accepting new patients
Pallicare, Inc Family CurrentSince Apr 9, 2024 Accepting new patients
Etmc Physician Group Inc. CurrentSince Feb 1, 2022 Accepting new patients
Starks Medical Past Accepting new patients
Legend Healthcare Jacksonville, LLC PastSince Apr 30, 2003 Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

Interoperability endpoints

  • Direct secure messaging: deanna.bishop.1@26850.direct.athenahealth.com

Organizations & group practices 5

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 2

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": "1432512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1972982866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BX 632040",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75963",
            "telephone_number": "936-560-5413",
            "fax_number": "936-552-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S. UNIVERSITY DR",
            "address_2": "EAST TEXAS COMMUNITY HEALTH SERVICES, INC.",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75961",
            "telephone_number": "936-560-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "DEANNA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-25",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "PERRY",
            "middle_name": "ELLEN",
            "prefix": "MRS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.