Individual provider Active NPI

Laquatre R. Rhodes, DO, MS

  • Pediatric Gastroenterology Physician
  • Prosper, TX
National Provider Identifier
1194169961
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
T9023 Issued in TX
Practice address
4200 W University Dr
Prosper, TX 75078-9805
Phone
(682) 303-4200
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X T9023 TX Primary

Addresses

Primary practice location

4200 W University Dr
Prosper, TX 75078-9805

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kputty185098@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190717000303 LA Practitioner - GastroenterologyPractitioner - Pediatric Medicine 5496050726 Reassigns benefits to 1 organization
I20220825003042 TX Practitioner - Pediatric Medicine 5496050726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook Childrens Physician NetworkGroup PAC ID 7719884584, 307 clinicians

Practice addresses (Care Compare)

1500 Cooper St
Fort Worth, TX 76104-2710
Phone (682) 885-4007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
T9023TXMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network CurrentSince Aug 29, 2022 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Aug 15, 2019 Accepting new patients
Cook Children'S Physician Network CurrentSince Aug 29, 2022 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

4200 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: kputty185098@cookchildrens.direct-ci.com
  • Direct secure messaging: lrhodes187180@cookchildrens.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1194169961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789805",
            "telephone_number": "682-303-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "LAQUATRE",
        "middle_name": "R.",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "T9023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kputty185098@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4200 W University Dr",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750789805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.