David Walton Didlake, AG-ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1074220 Issued in TX

Practice address

2821 E President George Bush Hwy Ste 505
Richardson, TX 75082-4278

Phone

(214) 943-1191

Fax

(214) 599-2601

NPI assigned

Aug 4, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Richardson Medical Center Hospital, Richardson, TX, CCN 450537

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddidlake188988@dm.mhd.com

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.

• Medhealth

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Medhealth

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690

  Single Specialty

  NPD
• Advanced Pain & Rehabilitation Association PLLC

  • Physical Medicine & Rehabilitation Physician
  • Wylie, TX
  • NPI 1215404637

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Richardson, TX
  • NPI 1033165501
  Care Compare affiliation

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1215664768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 E PRESIDENT GEORGE BUSH HWY STE 505",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824278",
            "telephone_number": "214-943-1191",
            "fax_number": "214-599-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 E PRESIDENT GEORGE BUSH HWY STE 505",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824278",
            "telephone_number": "214-943-1191",
            "fax_number": "214-599-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDLAKE",
        "first_name": "DAVID",
        "middle_name": "WALTON",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1074220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Yasmir Diaz, CCC-SLP
• Diana Diaz
• Diana Elizabeth Diaz, M.S., CCC-SLP
• Monica Alexia Diaz, MAT
• Mahasen Dibeh
• Nancy A Didriksen, PHD
• Diet Staff LLC
• Dietgenics Nutrition Consulting Limited Liability Company
• Digitrace Care Services Inc
• Diligent Home Health Care LLC

• Acute Care Nurse Practitioner in Richardson, TX
• Providers in Richardson, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.