MR. JACK ROBERT THURMAN NURSE PRACTITIONER
NPI 1063091676
Nurse Practitioner - Acute Care in Dallas, TX
About Mr. Jack Robert Thurman Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JACK ROBERT THURMAN NURSE PRACTITIONER (NPI 1063091676) is an individual acute care provider in Dallas, Texas, licensed in Texas (1032756) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Jack Robert Thurman Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jack Thurman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Waco, TX 76712
- Reassigned Medicare billing, Texas enrollment
- 176 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension Providence
Acute Care Hospitals · Waco, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 75238 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jack Thurman's NPI number?
The NPI number for Jack Thurman is 1063091676. It was assigned to this individual provider in the NPPES registry on April 2, 2021.
Where is Jack Thurman located?
Jack Thurman practices at 9839 Elmcrest Dr, Dallas, TX 75238. The listed phone number is (214) 335-9717.
What is Jack Thurman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Jack Thurman enrolled in Medicare?
Yes. Jack Thurman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jack Thurman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Thurman reassigns Medicare benefits to Providence Health Alliance (Waco, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Thurman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jack Thurman accept?
Health plans from Blue Cross and Blue Shield of Texas and Moda Health Plan, Inc. list Jack Thurman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Jack Thurman affiliated with any hospitals?
According to CMS data, Jack Thurman is affiliated with Ascension Providence.
When was this NPI record last updated?
The NPPES record for Jack Thurman was last updated on April 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Jack Robert Thurman, NURSE PRACTITIONER · NPI 1063091676
Acute Care physician in Dallas, Texas. Individual provider, active in the CMS NPPES registry since April 2, 2021.
## Identity
- **NPI:** 1063091676 (Entity type: Individual)
- **Enumerated:** April 2, 2021
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 1032756 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 9839 ELMCREST DR, Dallas, TX 75238-1831
- **Phone:** (214) 335-9717
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Providence Health Alliance (NPI 1932210838, Waco, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** April 2, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1063091676) · Data from the CMS NPPES public registry.