| Communitymed PLLC | |
|
3591 Mckinney St Suite 200 Melissa TX 75454-9571 | |
| (972) 464-1611 | |
| (972) 464-1611 |
| Full Name | Communitymed PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3591 Mckinney St, Melissa, Texas |
| Authorized Official Name and Position | Gregory Blomquist (MANAGING MEMBER) |
| Authorized Official Contact | 4693603498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Communitymed PLLC 16775 Addison Rd Ste 200 Addison TX 75001-5654 Ph: (972) 464-1611 | Communitymed PLLC 3591 Mckinney St Suite 200 Melissa TX 75454-9571 Ph: (972) 464-1611 |
| NPI Number | 1821417072 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 06/03/2021 |
| Certification Date | 04/03/2021 |
| Medicare PECOS PAC ID | 9830315126 |
|---|---|
| Medicare Enrollment ID | O20140722002029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821417072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | () | Primary |
| 261QX0100X | Clinic/center - Occupational Medicine | () | Secondary |
| Provider Name | Brent E Gooden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457389660 PECOS PAC ID: 1052224813 Enrollment ID: I20031107000283 |
| Provider Name | Stacey Pearlman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770544199 PECOS PAC ID: 2365334620 Enrollment ID: I20040330001321 |
| Provider Name | Robbie C Brasel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043383201 PECOS PAC ID: 3870520562 Enrollment ID: I20050726000676 |
| Provider Name | Marsha L Niven |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033162961 PECOS PAC ID: 2365459633 Enrollment ID: I20060310000286 |
| Provider Name | Kevin S Marcum |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184631046 PECOS PAC ID: 9830193556 Enrollment ID: I20060911000453 |
| Provider Name | Kristy D Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982624029 PECOS PAC ID: 4880784032 Enrollment ID: I20071212000406 |
| Provider Name | Jenifer Lynn Branson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235312299 PECOS PAC ID: 2163506247 Enrollment ID: I20080227000877 |
| Provider Name | William Fieldsmith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114126703 PECOS PAC ID: 2567520778 Enrollment ID: I20081016000304 |
| Provider Name | Deepa Krishnamurthi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538487004 PECOS PAC ID: 0749237642 Enrollment ID: I20100929000519 |
| Provider Name | Theresa a Biedenbach |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649270604 PECOS PAC ID: 6507829819 Enrollment ID: I20101021001024 |
| Provider Name | Russell Cruz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598909434 PECOS PAC ID: 9830387380 Enrollment ID: I20101228000146 |
| Provider Name | Kenneth a Dakin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740420306 PECOS PAC ID: 0749465805 Enrollment ID: I20110505000070 |
| Provider Name | Anton V Appelqvist |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205094430 PECOS PAC ID: 9032380878 Enrollment ID: I20110927000597 |
| Provider Name | Velislava Middleton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144508912 PECOS PAC ID: 4981878998 Enrollment ID: I20111130000625 |
| Provider Name | Linh Huynh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518178078 PECOS PAC ID: 1456475987 Enrollment ID: I20120717000305 |
| Provider Name | Doffou J Choho |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134486749 PECOS PAC ID: 9234395153 Enrollment ID: I20120723000176 |
| Provider Name | Katherine Vern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346538659 PECOS PAC ID: 0244489466 Enrollment ID: I20121003000907 |
| Provider Name | Casey Lynn Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649523861 PECOS PAC ID: 8527219104 Enrollment ID: I20121107000347 |
| Provider Name | Gregory Blomquist |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962625087 PECOS PAC ID: 4880823012 Enrollment ID: I20140210000412 |
| Provider Name | Dane Thurston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225255235 PECOS PAC ID: 4183853120 Enrollment ID: I20140214001057 |
| Provider Name | Jay Mitchell Pribble |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508097155 PECOS PAC ID: 0840424560 Enrollment ID: I20141024002150 |
| Provider Name | Megan M Perkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821405432 PECOS PAC ID: 3577878149 Enrollment ID: I20150812007451 |
| Provider Name | Jennifer K. Slater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528437316 PECOS PAC ID: 8921318387 Enrollment ID: I20151116000131 |
| Provider Name | Nefertiti a Mcelroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073939153 PECOS PAC ID: 3678798501 Enrollment ID: I20160316001649 |
| Provider Name | Robert Blaine Rozell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881064301 PECOS PAC ID: 4486953247 Enrollment ID: I20160428001323 |
| Provider Name | Rodney G Shultz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245216084 PECOS PAC ID: 3678562097 Enrollment ID: I20170221001069 |
| Provider Name | Elijah M Nyasende |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760891568 PECOS PAC ID: 9032482716 Enrollment ID: I20170831000066 |
| Provider Name | Colleen M Thurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942670922 PECOS PAC ID: 3870866288 Enrollment ID: I20170907000304 |
| Provider Name | Angelina Payne |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639682065 PECOS PAC ID: 3577820067 Enrollment ID: I20171208002470 |
| Provider Name | Ruth-ellen Easter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568970192 PECOS PAC ID: 7719247006 Enrollment ID: I20180206000945 |
| Provider Name | Ryan C Wolford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396245320 PECOS PAC ID: 6103187125 Enrollment ID: I20180307001569 |
| Provider Name | Lauren Delong |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932611951 PECOS PAC ID: 9234488818 Enrollment ID: I20180814004197 |
| Provider Name | Dai Tri Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285152769 PECOS PAC ID: 1355693748 Enrollment ID: I20181012001757 |
| Provider Name | Saul H Pennington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891281648 PECOS PAC ID: 1850644303 Enrollment ID: I20181030002193 |
| Provider Name | Cherie Haynes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497101612 PECOS PAC ID: 4082958855 Enrollment ID: I20181205000851 |
| Provider Name | Sarah E Mertz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316418635 PECOS PAC ID: 0244573186 Enrollment ID: I20190516002674 |
| Provider Name | Erin Christine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699238303 PECOS PAC ID: 2365785003 Enrollment ID: I20190520002491 |
| Provider Name | Brittany R Reineke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508412610 PECOS PAC ID: 0648501841 Enrollment ID: I20191018000631 |
| Provider Name | Ryan Hawkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497081137 PECOS PAC ID: 9638442429 Enrollment ID: I20191021002501 |
| Provider Name | Cuong Bui Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184190803 PECOS PAC ID: 2466784954 Enrollment ID: I20191104000164 |
| Provider Name | Amy L Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821572694 PECOS PAC ID: 8224460480 Enrollment ID: I20191111000271 |
| Provider Name | Trudian Lester-haughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073170411 PECOS PAC ID: 7113359175 Enrollment ID: I20191112002631 |
| Provider Name | Elizabeth Vogt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447732326 PECOS PAC ID: 1658701602 Enrollment ID: I20200415002518 |
| Provider Name | Betsy J Figg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104472141 PECOS PAC ID: 3072930726 Enrollment ID: I20200827000017 |
| Provider Name | Carmen Lauren Cox |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750858213 PECOS PAC ID: 7416377015 Enrollment ID: I20201021000222 |
| Provider Name | Justin L Jones |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174190094 PECOS PAC ID: 4880096072 Enrollment ID: I20210709002832 |
| Provider Name | Gloria George |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215528195 PECOS PAC ID: 2961807581 Enrollment ID: I20210819003780 |
| Provider Name | Whitney Nicole Watson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790328243 PECOS PAC ID: 8527463637 Enrollment ID: I20210826002229 |
| Provider Name | Aparna Mohana Krishnan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770198038 PECOS PAC ID: 0648660654 Enrollment ID: I20211207000674 |
| Provider Name | Curtiss James Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245839232 PECOS PAC ID: 0749672749 Enrollment ID: I20220125002714 |
| Provider Name | Alison Harvey Ewing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568037596 PECOS PAC ID: 9436543931 Enrollment ID: I20220228000149 |
| Provider Name | Lauren Michelle Amburgey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245698828 PECOS PAC ID: 4789079377 Enrollment ID: I20220317001418 |
| Provider Name | Mackenzie Roth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831765759 PECOS PAC ID: 4082019955 Enrollment ID: I20220509001892 |
| Provider Name | Salima Nota |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174279756 PECOS PAC ID: 3375920267 Enrollment ID: I20220516000190 |
| Provider Name | Skyler Lynch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114346368 PECOS PAC ID: 7416331145 Enrollment ID: I20220830002578 |
| Provider Name | Nam Hoai Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760126528 PECOS PAC ID: 5496121618 Enrollment ID: I20221013000520 |
| Provider Name | Fawna R Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124658430 PECOS PAC ID: 5294102471 Enrollment ID: I20221031003066 |
| Provider Name | Claire Murphy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174959118 PECOS PAC ID: 6305073263 Enrollment ID: I20221109000737 |
| Provider Name | Benjamin Cheung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710651765 PECOS PAC ID: 0547639932 Enrollment ID: I20221206003137 |
| Provider Name | Bonnie Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831818483 PECOS PAC ID: 5294106647 Enrollment ID: I20230120002646 |
| Provider Name | Jeffrey Ngoc-duy Vu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093447492 PECOS PAC ID: 8921463902 Enrollment ID: I20230426001446 |
| Provider Name | Linda Nguyen Palsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164174033 PECOS PAC ID: 8921465253 Enrollment ID: I20230601001100 |
| Provider Name | Nicole Dauksavage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194423541 PECOS PAC ID: 9830557594 Enrollment ID: I20230628001078 |
| Provider Name | Tasha Lynn Albus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992588958 PECOS PAC ID: 7618324237 Enrollment ID: I20231103000723 |
| Provider Name | Justin Ryan Nickel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750167086 PECOS PAC ID: 5294183604 Enrollment ID: I20231126000086 |
| Provider Name | Isabella G Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740069798 PECOS PAC ID: 2062865322 Enrollment ID: I20240202001052 |
| Provider Name | Estrella K Pedroza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851176457 PECOS PAC ID: 8224472600 Enrollment ID: I20240214001731 |
| Provider Name | Brittany Seepersad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427810506 PECOS PAC ID: 7012354657 Enrollment ID: I20240319002040 |
| Provider Name | Karina M Brooke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205614963 PECOS PAC ID: 0749629996 Enrollment ID: I20240419002652 |
| Provider Name | Brittnee Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558146100 PECOS PAC ID: 0941654636 Enrollment ID: I20240604003667 |
| Provider Name | Mikala Becherer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275397028 PECOS PAC ID: 1052848892 Enrollment ID: I20241218002239 |
| Provider Name | Alfred Douglas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326463282 PECOS PAC ID: 9234666926 Enrollment ID: I20241219000054 |
| Provider Name | April Rachelle Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093216582 PECOS PAC ID: 3274840483 Enrollment ID: I20250321000312 |
| Provider Name | Caitlin Jarvis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922813104 PECOS PAC ID: 7911413208 Enrollment ID: I20250723001355 |
Melissa Family Medicine PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Sam Rayburn Hwy, Melissa, TX 75454 Phone: 469-215-2377 Fax: 469-215-2366 |
Communitymed Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3106 Mckinney St, Suite 100, Melissa, TX 75454 Phone: 972-464-1611 |
Communitymed Urgent Care System, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3591 Mckinney St, Suite 200, Melissa, TX 75454 Phone: 972-464-1611 Fax: 972-464-1611 |
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