Itasca Healing Medical Practice
NPI 1023867546 · Family Medicine Physician · Nacogdoches, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Itasca Healing Medical Practice is a Family Medicine Physician organization in Nacogdoches, TX (NPI 1023867546).
Provider details
- NPI number
- 1023867546
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Suzanna Fuller, Owner(936) 250-2062
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-05-16
- Last updated
- 2024-10-02
- Certified
- 2024-10-02
Frequently asked questions
- What is Itasca Healing Medical Practice's NPI number?
- Itasca Healing Medical Practice's National Provider Identifier (NPI) is 1023867546, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Itasca Healing Medical Practice?
- Itasca Healing Medical Practice is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Itasca Healing Medical Practice located?
- Itasca Healing Medical Practice's practice location on file with NPPES is 223 King St, Nacogdoches, TX 75961-4421.
- What is Itasca Healing Medical Practice's phone number?
- The practice phone number listed in the NPPES registry for Itasca Healing Medical Practice is (936) 622-0552.
- Does Itasca Healing Medical Practice accept Medicare?
- Itasca Healing Medical Practice is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Itasca Healing Medical Practice?
- The authorized official listed on Itasca Healing Medical Practice's NPPES record is Suzanna Fuller, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Itasca Healing Medical Practice's NPI active?
- Yes — Itasca Healing Medical Practice's NPI (1023867546) is active in the NPPES registry as of the last update on 2024-10-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.