Individual provider Active NPI

Jessica Laura Reaves, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1154890044
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP139781 Issued in TX
Practice address
7777 Forest LN Ste C339
Dallas, TX 75230-2544
Phone
(972) 566-8855
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X AP139781 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste C339
Dallas, TX 75230-2544

Mailing address

7777 Forest LN Ste C339
Dallas, TX 75230-2544
Phone (972) 566-8855

Other practice location 1

7200 State Highway 161 Ste 230
Irving, TX 75039-3829
Phone (972) 566-8855

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
I20190130000948 TX Practitioner - Nurse Practitioner 9234476169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

621 N Hall St
Suite 120
Dallas, TX 75226-1307
Phone (214) 820-6856

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP139781TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Single Specialty CurrentSince Sep 19, 2022 Accepting new patients
Healthtexas Provider Network Single Specialty CurrentSince Sep 19, 2022 Accepting new patients
Park Cities Dermatology, PA Single Specialty PastSince Jan 21, 2019 Accepting new patients
Healthtexas Provider Network Single Specialty Past Accepting new patients

Locations

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

621 N Hall St
Ste 120
Dallas, TX 75226
Phone (214) 820-1723

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

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

Interoperability endpoints

  • Direct secure messaging: jreaves1116712@direct.sw.org

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 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": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1154890044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C339",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302544",
            "telephone_number": "972-566-8855",
            "fax_number": "972-566-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C339",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302544",
            "telephone_number": "972-566-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 State Highway 161 Ste 230",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750393829",
            "country_code": "US",
            "telephone_number": "972-566-8855",
            "fax_number": "469-713-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAVES",
        "first_name": "JESSICA",
        "middle_name": "LAURA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP139781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.