Organization Active NPI

Splendid Cedar Healthcare PLLC

  • Nurse Practitioner
  • Richardson, TX
National Provider Identifier
1063185924
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SPLENDID CEDAR HEALTHCARE PLLC
Practice address
1101 E Arapaho Rd Ste 140
Richardson, TX 75081-2352
Phone
(469) 592-9371
Fax
(469) 519-4945
NPI assigned
Jul 27, 2021
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Charlotte F Isah, DNPNPI 1366883035
Title
Nurse Practitioner
Phone
(214) 716-9606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

1101 E Arapaho Rd Ste 140
Richardson, TX 75081-2352

Mailing address

1101 E Arapaho Rd Ste 140
Richardson, TX 75081-2352
Phone (469) 592-9371

Other practice location 1

1100 Summer Ln
McKinney, TX 75071-1230
Phone (214) 716-9606

Other identifiers 1

IdentifierTypeStateIssuer
4320061MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL WWW.SPLENDIDCEDAR.COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210902002248 TX Part B Supplier - Clinic/Group Practice 2264838002 Receives reassigned benefits from 1 practitioner
Practice locations: Richardson, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2233163Splendid Cedar Healthcare, PLLC1101 E Arapaho Rd Suite 140, Richardson, TX 75081Certificate of waiverAug 19, 2027

National Provider Directory

National Provider Directory

Locations

1101 E Arapaho Rd
Ste 140
Richardson, TX 75081
Phone (469) 592-9371

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1063185924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E ARAPAHO RD STE 140",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750812352",
            "telephone_number": "469-592-9371",
            "fax_number": "469-519-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E ARAPAHO RD STE 140",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750812352",
            "telephone_number": "469-592-9371",
            "fax_number": "469-519-4945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Summer Ln",
            "address_purpose": "LOCATION",
            "city": "McKinney",
            "state": "TX",
            "postal_code": "750711230",
            "country_code": "US",
            "telephone_number": "214-716-9606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPLENDID CEDAR HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "ISAH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "214-716-9606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4320061",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.SPLENDIDCEDAR.COM",
            "affiliation": "N",
            "endpointDescription": "OFFICE",
            "address_1": "1101 E Arapaho Rd Ste 140",
            "city": "Richardson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750812352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.