Active NPI
Ryan Nodurft, LCSW
- Clinical Social Worker
- Dallas, TX
National Provider Identifier
1316334352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 52781
- Practice address
- 6363 Forest Park Rd
7TH Floor Suite 749
Dallas, TX 75390-9121 - Phone
- (214) 645-8500
- Fax
- (214) 645-3775
- NPI assigned
- Apr 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 52781 | TX | Primary |
Addresses
Primary practice location
6363 Forest Park Rd
7TH Floor Suite 749
Dallas, TX 75390-9121
Mailing address
PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150526001531 | TX | Practitioner - Clinical Social Worker | 8022338458 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52781 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connections Physicians Group | Current | Accepting new patients | |
| Connections Wellness Group | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Past | Accepting new patients |
Locations
4907 S Collins St
Ste 121
Arlington, TX 76018
Phone (817) 417-9001
7290 Virginia Pkwy
Ste 2100
McKinney, TX 75071
6101 W Plano Pkwy
Ste 230
Plano, TX 75093
Phone (469) 613-3390
6101 W Plano Pkwy
Ste 240
Plano, TX 75093
Phone (469) 312-2107
Organizations & group practices 3
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.
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- Internal Medicine Physician
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- NPI 1760452767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487462400000",
"number": "1316334352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845347",
"city": "DALLAS",
"state": "TX",
"postal_code": "752845347",
"telephone_number": "214-645-0624",
"fax_number": "214-645-0078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6363 FOREST PARK RD",
"address_2": "7TH FLOOR SUITE 749",
"city": "DALLAS",
"state": "TX",
"postal_code": "753909121",
"telephone_number": "214-645-8500",
"fax_number": "214-645-3775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NODURFT",
"first_name": "RYAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2017-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "52781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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, 2017; 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.