Individual provider Active NPI

Priscilla Fernandez, RD,LD

  • Registered Dietitian
  • Dallas, TX
National Provider Identifier
1265025365
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
811434 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-0153
NPI assigned
Feb 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 811434 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

4527 Via San Antonio
Dallas, TX 75211-3550
Phone (972) 464-8565

Other names 1

  • Priscilla Duran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211025002588 TX Practitioner - Registered Dietitian Or Nutrition Professional 2264820299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
811434TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District CurrentSince Sep 1, 2021 Accepting new patients
Dallas County Hospital District CurrentSince Sep 1, 2021 Accepting new patients

Locations

4811 Harry Hines Blvd
Ste C
Dallas, TX 75235
Phone (214) 266-1257

5151 Maple Ave
Fl 4
Dallas, TX 75235
Phone (214) 590-0153

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

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": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1265025365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4527 VIA SAN ANTONIO",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752113550",
            "telephone_number": "972-464-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "PRISCILLA",
        "name_prefix": "Mrs.",
        "credential": "RD,LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "811434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "DURAN",
            "credential": "RD,LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.