Individual provider Active NPI

Andrea E. Cheneweth, FNP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1275548109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
635486 Issued in TX
Practice address
6250 John Ryan Dr
Fort Worth, TX 76132-4115
Phone
(817) 346-9800
Fax
(817) 346-9881
NPI assigned
Jul 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 635486 TX Primary

Addresses

Primary practice location

6250 John Ryan Dr
Fort Worth, TX 76132-4115

Mailing address

6250 John Ryan Dr
Fort Worth, TX 76132-4115
Phone (817) 346-9800

Other identifiers 1

IdentifierTypeStateIssuer
635486OtherTXSTATE 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
I20120829000396 TX Practitioner - Nurse Practitioner 3971750704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

350 Mercedes St
Benbrook, TX 76126-2593
Phone (817) 717-5390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
635486TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa M Buell, M.D., P.a. CurrentSince Jun 15, 2012 Accepting new patients

Locations

6250 John Ryan Dr
Fort Worth, TX 76132
Phone (817) 346-9880

Interoperability endpoints

  • Direct secure messaging: andrea.cheneweth@lmbmp.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JFFEBD/Endpoint/JFFEBD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275548109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324115",
            "telephone_number": "817-346-9800",
            "fax_number": "817-346-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324115",
            "telephone_number": "817-346-9800",
            "fax_number": "817-346-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENEWETH",
        "first_name": "ANDREA",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "635486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "635486",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.