Individual provider Active NPI

Tikisha Newton, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1184500548
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1196124 Issued in TX
Practice address
3301 Stalcup Rd
Fort Worth, TX 76119-1726
Phone
(817) 702-1100
NPI assigned
Aug 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1196124 TX Primary

Addresses

Primary practice location

3301 Stalcup Rd
Fort Worth, TX 76119-1726

Mailing address

PO Box 732973
Dallas, TX 75373-2973

Other practice location 1

4055 Valley View Ln Ste 700
Dallas, TX 75244-5045
Phone (855) 984-5121

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
I20251008003151 TX Practitioner - Nurse Practitioner 3870090566 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 W Magnolia Ave
Fort Worth, TX 76104-7644

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4810 B Spicewood Springs Rd
Austin, TX 78759-7838

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1196124TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Sep 24, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Sep 30, 2025 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

3301 Stalcup Rd
Ft Worth, TX 76119
Phone (817) 702-7209

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1184500548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753732973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 STALCUP RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761191726",
            "telephone_number": "817-702-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Valley View Ln Ste 700",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752445045",
            "country_code": "US",
            "telephone_number": "855-984-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "TIKISHA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1196124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.