NPIMap

Individual provider Active NPI

Amy Rae Hederman, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1114579059
Registry record updated Sep 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141903 Issued in TX
Practice address
6201 Harry Hines Blvd
Dallas, TX 75390-2210
Phone
(214) 633-4700
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP141903 TX Primary

Addresses

Primary practice location

6201 Harry Hines Blvd
Dallas, TX 75390-2210

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-7201

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (214) 590-8000

Other names 1

  • Amy Rae Vell Former name

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
I20191106000625 TX Practitioner - Nurse Practitioner 1254663503 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8000

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP141903TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Dec 13, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2022 Accepting new patients
Beaumont Emergency Medicine Associates PLLC CurrentSince Nov 4, 2020 Accepting new patients
Baptist Physician Network CurrentSince Sep 8, 2019 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Healthtexas Provider Network CurrentSince Dec 13, 2021 Accepting new patients

Locations

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

3070 College St
Ste 100B
Beaumont, TX 77701
Phone (409) 212-7110

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

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

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

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

2021 N MacArthur Blvd
Ste 115
Irving, TX 75061
Phone (972) 253-4315

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

925 E Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 912-8560

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 8

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662249600000",
    "number": "1114579059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753902210",
            "telephone_number": "214-633-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907201",
            "country_code": "US",
            "telephone_number": "214-590-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDERMAN",
        "first_name": "AMY",
        "middle_name": "RAE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "VELL",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.