Individual provider Active NPI

Kara Deanne Petty, FNP-C

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1083943450
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP132483 Issued in TX
Practice address
400 N Saint Paul St Ste 1140
Dallas, TX 75201-3145
Phone
(972) 449-0540
Fax
(972) 449-0550
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP132483 TX Primary

Addresses

Primary practice location

400 N Saint Paul St Ste 1140
Dallas, TX 75201-3145

Mailing address

400 N Saint Paul St Ste 1140
Dallas, TX 75201-3145
Phone (972) 449-0540

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
I20170616000193 TX Practitioner - Nurse Practitioner 9234407263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Practice addresses (Care Compare)

115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671

Hospital & facility affiliations

  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132483TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC Nurse Practitioner CurrentSince May 15, 2017 Accepting new patients
North Texas Physician Services, PLLC Nurse Practitioner CurrentSince May 19, 2024 Accepting new patients
Access Telecare California, P.C. Nurse Practitioner PastSince Sep 18, 2023 Accepting new patients

Locations

1717 Main St
Ste 5850
Dallas, TX 75201
Phone (469) 694-5512

400 N Saint Paul St
Ste 1140
Dallas, TX 75201
Phone (913) 449-0540

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 439-4052

719 W Coke Rd
Winnsboro, TX 75494
Phone (903) 342-3961

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083943450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N SAINT PAUL ST STE 1140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013145",
            "telephone_number": "972-449-0540",
            "fax_number": "972-449-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N SAINT PAUL ST STE 1140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013145",
            "telephone_number": "972-449-0540",
            "fax_number": "972-449-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "KARA",
        "middle_name": "DEANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.