JEREMY THOMAS DIVER (NPI# 1679913354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679913354 |
| Entity Type | Individual |
| Full Name | JEREMY THOMAS DIVER |
| Credential | PA-C |
| Practice Address |
6316 Precinct Line Rd Hurst TX 76054-2766 |
| Mailing Address |
1512 Teasley Ln Denton TX 76205-7282 |
| Practice Telephone | 8176052525 |
| Mailing Telephone | 9403820980 |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2020-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6316 PRECINCT LINE RD |
| City | HURST |
| State | TX |
| Zip Code | 76054-2766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557005 | Ailey Ann Folsom | Nurse Practitioner | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2005-09-12 |
| 1740609361 | Kshitij Bhalani | Emergency Medicine | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2014-04-10 |
| 1750709762 | Karly Slayton | Nurse Practitioner | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2014-04-07 |
| 1346596103 | Deeni Luz De La Rosa Perez | Pediatrics | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2012-07-31 |
| 1700157708 | Audra Collins | Physician Assistant | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2012-01-23 |
| 1174859375 | Cook Children's Northeast Hospital | Clinic/Center | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2009-10-22 |
| 1235462870 | Cook Children's Northeast Hospital | Emergency Medicine | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2009-09-15 |
| 1104021351 | Jennifer L Roye | Nurse Practitioner | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2007-06-18 |
| 1235299132 | Cook Childrens Northeast Hospital, LLC | Clinic/Center | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2006-12-11 |
| 1831288471 | Rebecca L Walker | Pediatrics | 6316 Precinct Line Rd, Hurst, TX 76054-2766 | 2006-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942856224 | Nancy Lopez | Speech-Language Pathologist | 6168 Bentridge Rd, Hurst, TX 76054 | 2019-08-13 |
| 1942771134 | James L Thomason Md | Psychiatry & Neurology | 769 Lonesome Dove Trail, Hurst, TX 76054 | 2018-12-16 |
| 1114498672 | Alpha Hyperbarics Pllc | Preventive Medicine | 1845 Precinct Line Road, Ste 105, Hurst, TX 76054 | 2018-12-10 |
| 1922555234 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 809 W Harwood Rd Ste 103, Hurst, TX 76054 | 2016-09-02 |
| 1427422765 | Stephen Craig Sims | Dentist | 1725 Cimarron Trail, Suite 1, Hurst, TX 76054 | 2015-11-24 |
| 1629464342 | Meredith Drake | Pediatrics | 731 Martin Road, Hurst, TX 76054 | 2015-04-09 |
| 1104236454 | Jessica Shepard,ma,lpc | Counselor | 1817 Harwood Court, Hurst, TX 76054 | 2014-05-07 |
| 1801225016 | Hearing Essentials of Texas, Inc. | Clinic/Center | 672 Grapevine Hwy, Hurst, TX 76054 | 2013-11-07 |
| 1265787337 | Sarah Michele Talbott | Optometrist | 2817 Hurstview Dr., Hurst, TX 76054 | 2012-07-16 |
| 1174801617 | Robert Harry Levy | Dentist | 828 Harwood Rd, Tarrant County College Dental Hygiene Program, Hurst, TX 76054 | 2011-08-02 |
| Find all providers in zip 76054 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912306093 | Shruti Desai | Physician Assistant | 400 Mid Cities Blvd, Hurst, TX 76054-2430 | 2014-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.