Individual provider Active NPI

Editha Guevara, CNP

  • Gerontology Nurse Practitioner
  • Plano, TX
National Provider Identifier
1114451879
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP132349 Issued in TX
Practice address
1100 Allied Dr
Plano, TX 75093-5348
Phone
(877) 814-4488
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP132349 TX
Gerontology Nurse Practitioner 363LG0600X AP132349 TX Primary

Addresses

Primary practice location

1100 Allied Dr
Plano, TX 75093-5348

Mailing address

PO Box 844596
Dallas, TX 75284-4596
Phone (440) 879-0081

Other names 1

  • Editha Rome Guevara Former name

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
I20170502000661 TX Practitioner - Nurse Practitioner 8527345404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4708 Alliance Blvd
Suite 540
Plano, TX 75093-5339
Phone (469) 800-6200

Hospital & facility affiliations

  • The Heart Hospital Baylor Denton Hospital, Denton, TX, CCN 450893
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025
  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132349TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Apr 14, 2024 Accepting new patients
Texas Heart Hospital of the Southwest LLP CurrentSince Mar 25, 2017 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Apr 14, 2024 Accepting new patients
Texas Heart Hospital of the Southwest LLC CurrentSince Mar 25, 2017 Accepting new patients

Locations

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4708 Alliance Blvd
Ste 540
Plano, TX 75093
Phone (469) 800-6200

1100 Allied Dr
Plano, TX 75093
Phone (469) 814-3278

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

Organizations & group practices 5

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 3

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1114451879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844596",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844596",
            "telephone_number": "440-879-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ALLIED DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935348",
            "telephone_number": "877-814-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "EDITHA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132349",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP132349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDITHA",
            "last_name": "ROME GUEVARA",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.