Active NPI
Marilyn J. Hannafious, WHCNP
- Women's Health Nurse Practitioner
- Dallas, TX
National Provider Identifier
1083770945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 585550
- Practice address
- 9202 Elam Rd
Southeast Dallas Women'S Health Center
Dallas, TX 75217-4151 - Phone
- (214) 266-1500
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 585550 | TX | Primary |
Addresses
Primary practice location
9202 Elam Rd
Southeast Dallas Women'S Health Center
Dallas, TX 75217-4151
Mailing address
PO Box 660599
Dallas, TX 75266-0599
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140078016 | Medicaid | TX | |
| 140078026 | Medicaid | TX | |
| 8Y2909 | Other | TX | BLUE CROSS BLUE SHIELD |
| 140078021 | Medicaid | TX | |
| 140078023 | Medicaid | TX | |
| 140078019 | Medicaid | TX | |
| 140078022 | Medicaid | TX | |
| 140078027 | Medicaid | TX | |
| 140078020 | Medicaid | TX | |
| 140078024 | Medicaid | TX | |
| 140078025 | Medicaid | TX | |
| 140078028 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 585550 | TX | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239580800000",
"number": "1083770945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 660599",
"city": "DALLAS",
"state": "TX",
"postal_code": "752660599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9202 ELAM RD",
"address_2": "SOUTHEAST DALLAS WOMEN'S HEALTH CENTER",
"city": "DALLAS",
"state": "TX",
"postal_code": "752174151",
"telephone_number": "214-266-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAFIOUS",
"first_name": "MARILYN",
"middle_name": "J.",
"credential": "WHCNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2009-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "TX",
"license": "585550",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078016",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078026",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8Y2909",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078021",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078023",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078019",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078022",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078027",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078020",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078024",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078025",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140078028",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.