Individual provider Active NPI

Charissa Parker, FNP-C

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1225503394
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP137750 Issued in TX
Practice address
3604 Live Oak St Ste 100
Dallas, TX 75204-6169
Phone
(214) 358-2300
Fax
(214) 366-6330
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP137750 TX Primary

Addresses

Primary practice location

3604 Live Oak St Ste 100
Dallas, TX 75204-6169

Mailing address

1505 LBJ Fwy Ste 700
Dallas, TX 75234-6065
Phone (214) 358-2300

Other practice location 1

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-6169
Phone (214) 648-3111

Other identifiers 2

IdentifierTypeStateIssuer
AP137750OtherTXSTATE LICENSE
840304OtherTXRN LICENSE

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
I20211102001156 TX Practitioner - Nurse Practitioner 6507254026 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP137750TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 5, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 5, 2024 Accepting new patients
Dallas Nephrology Associates CurrentSince Aug 22, 2022 Accepting new patients
Dallas Nephrology Associates CurrentSince Aug 22, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The Center for Neurology and Neurophysiology, P.a. Neurology PastSince Oct 28, 2010 Accepting new patients

Locations

3604 Live Oak St
Ste 100
Dallas, TX 75204

1420 Viceroy Dr
Dallas, TX 75235

1505 Lyndon B Johnson Fwy
Ste 700
Dallas, TX 75234
Phone 21435823006012

1150 N Bishop Ave
Ste 100
Dallas, TX 75208
Phone (214) 956-8200

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7609 Preston Rd
Plano, TX 75024
Phone (214) 456-2444

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1225503394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LBJ FWY STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752346065",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 LIVE OAK ST STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046169",
            "telephone_number": "214-358-2300",
            "fax_number": "214-366-6330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd Stop 7200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753906169",
            "country_code": "US",
            "telephone_number": "214-648-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "CHARISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP137750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP137750",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "840304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.