Adrian Denise Childress, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04520 Issued in TX

Practice address

1317 N Hillcrest Dr
Sulphur Springs, TX 75482-2091

Phone

(903) 438-1110

Fax

(903) 438-1107

NPI assigned

Aug 17, 2009

Last updated

Jan 23, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: adrian.childress.1@11247.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/11247/brand/1/csg/1/fhir/r4

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.

• Jordan's Place Pediatrics, PA

  • Rural Health Clinic/Center
  • Sulphur Springs, TX
  • NPI 1063277903
  NPD (past)
• Jordan's Place Pediatrics, PA

  • Primary Care Clinic/Center
  • Sulphur Springs, TX
  • NPI 1245419431
  NPD (past)

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1164654737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N HILLCREST DR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822091",
            "telephone_number": "903-438-1110",
            "fax_number": "903-438-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N HILLCREST DR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822091",
            "telephone_number": "903-438-1110",
            "fax_number": "903-438-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "ADRIAN",
        "middle_name": "DENISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "752950731",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281003803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281003801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selena Cervantez-Aranda
• Keith Chastain, PHARM.D
• Sadie Elizabeth Chester
• Ashley Nicole Chevalier
• Child & Family Therapy Center
• Christus Hopkins Health Alliance (Christus Mother Frances - Sulphur Springs)
• Christus Hopkins Health Alliance (Christus Mother Frances - Sulphur Springs)
• Christus Trinity Clinic
• Stacy Alan Cody, RPH
• Bridgette Denise Coker, M.D.

• Physician Assistant in Sulphur Springs, TX
• Providers in Sulphur Springs, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.