Meghan Patricia Gustafson, RN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1096404 Issued in TX

Practice address

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-1002

Phone

(214) 648-3111

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD (past)

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1235252982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4823 ISLEWORTH DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750384500",
            "telephone_number": "636-544-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753901002",
            "telephone_number": "214-648-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "MEGHAN",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "RN 131621",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1096404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "endpointDescription": "BJC",
            "affiliationName": "St. Louis Children's Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Childrens Pl",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Josaphat Gurrola
• Shova Gurung, NP
• Emily Gurwitz
• Kathryn Gurwitz
• Anna Marie Gustafson-Clum, LMSW
• Gustavo H Day MD PA
• Gwenn Carol Guthrie, PT
• James Guthrie, LCDC
• Rebecca Spalding Guthrie, LCSW
• Irina Yuseth Gutierrez Puentes, MD

• Pediatric Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.