Individual provider Active NPI

Dora A. Fast, FNP

  • Family Nurse Practitioner
  • Cotulla, TX
National Provider Identifier
1053733014
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
738349 Issued in TX
Practice address
105 S. Stewart St.
Cotulla, TX 78014
Phone
(830) 879-3047
NPI assigned
Jan 10, 2014
Last updated
Jan 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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 738349 TX Primary

Addresses

Primary practice location

105 S. Stewart St.
Cotulla, TX 78014

Mailing address

605 Leona
Cotulla, TX 78014
Phone (830) 879-2256

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
I20170807002621 TX Order and Referring Only - Nurse Practitioner 4688722887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
738349TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Rural Health Services, Inc. Family Past Accepting new patients
South Texas Rural Health Services Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1053733014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 LEONA",
            "city": "COTULLA",
            "state": "TX",
            "postal_code": "78014",
            "telephone_number": "830-879-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S. STEWART ST.",
            "city": "COTULLA",
            "state": "TX",
            "postal_code": "78014",
            "telephone_number": "830-879-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "DORA",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "738349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cotulla, TX

Sources for this page

Verify at the official NPI Registry.