NPIMap

Individual provider Active NPI

Elizabeth John Reddiar, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Garland, TX
National Provider Identifier
1073951257
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
827862 Issued in TX
Practice address
4421 Merlin Dr
Garland, TX 75043-2671
Phone
(973) 944-4795
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 827862 TX Primary

Addresses

Primary practice location

4421 Merlin Dr
Garland, TX 75043-2671

Mailing address

4421 Merlin Dr
Garland, TX 75043-2671
Phone (973) 944-4795

Other names 1

  • Elizabeth John Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ereddiar227459@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518001048 TX Practitioner - Nurse Practitioner 9436448230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

303 E Overton Rd
Parkland Health
Dallas, TX 75216-5946
Phone (214) 266-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
827862TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 1, 2016 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 1, 2016 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: ereddiar227459@direct.sw.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1073951257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 MERLIN DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750432671",
            "telephone_number": "973-944-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 MERLIN DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750432671",
            "telephone_number": "973-944-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDIAR",
        "first_name": "ELIZABETH",
        "middle_name": "JOHN",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "827862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ereddiar227459@direct.sw.org",
            "affiliation": "N",
            "address_1": "4009 Worth St Ste B",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752461608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "JOHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.