Active NPI
Nidish Jose, AGNP-C
- Adult Health Nurse Practitioner
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 789098
- Practice address
- 3044 Hidden Valley Dr
Fort Worth, TX 76177-2716 - Phone
- (469) 844-7072
- Fax
- (817) 697-4580
- NPI assigned
- Jul 13, 2017
- Last updated
- Jul 30, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 789098 | TX | Primary |
Addresses
Primary practice location
3044 Hidden Valley Dr
Fort Worth, TX 76177-2716
Mailing address
3044 Hidden Valley Dr
Fort Worth, TX 76177-2716
Other practice location 1
2700 Tibbets Dr Ste 300
Bedford, TX 76022-5938
Phone (817) 484-0233
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Carrollton, TX 75006
Phone (817) 823-5464
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 789098 | TX | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearview Primary Care PLLC | Adult Health | Current | Accepting new patients |
| Heritage Parkway Medical PLLC | Current | Accepting new patients | |
| Sunnyssix, PLLC | Current | Accepting new patients | |
| Ry Jay Z LLC | Past | Accepting new patients |
Locations
2410 Luna Rd
Ste 202
Carrollton, TX 75006
Phone (214) 592-1854
2410 Luna Rd
Ste 204
Carrollton, TX 75006
Phone (469) 844-7072
2410 Luna Rd
Ste 248
Carrollton, TX 75006
Phone (214) 422-8265
2410 Luna Rd
Ste 250
Carrollton, TX 75006
Phone (817) 300-5457
2410 Luna Rd
Ste 280
Carrollton, TX 75006
Phone (817) 823-5464
2321 Ira E Woods Ave
Ste 120
Grapevine, TX 76051
Phone (469) 844-7072
Organizations & group practices 4
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.
-
- Adult Health Nurse Practitioner
- Carrollton, TX
- NPI 1700733367
-
dba Community First Primary Care
- Gerontology Nurse Practitioner
- Carrollton, TX
- NPI 1972016384
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Wills Point, TX
- NPI 1902600133
-
dba Nursing Services and Consultants of Laredo
- Home Health Agency
- Benavides, TX
- NPI 1053404236
-
- Home Health Agency
- Corpus Christi, TX
- NPI 1356358543
-
- Home Health Agency
- Plano, TX
- NPI 1447653696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1104348903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3044 HIDDEN VALLEY DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761772716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3044 HIDDEN VALLEY DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761772716",
"telephone_number": "469-844-7072",
"fax_number": "817-697-4580"
}
],
"practiceLocations": [
{
"address_1": "2700 Tibbets Dr Ste 300",
"address_purpose": "LOCATION",
"city": "Bedford",
"state": "TX",
"postal_code": "760225938",
"country_code": "US",
"telephone_number": "817-484-0233",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOSE",
"first_name": "NIDISH",
"credential": "AGNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-13",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "789098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.