Individual provider Active NPI

Samantha Loredo, APRN

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1316782964
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1169639 Issued in TX
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(817) 926-2544
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1169639 TX Primary

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

Mailing address

9621 Mint Hill Dr
Fort Worth, TX 76108-2198
Phone (817) 718-2917

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
I20250102001239 TX Practitioner - Nurse Practitioner 9032646047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Nov 4, 2024 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 4, 2024 Accepting new patients
Healthtexas Provider Network Current Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Interoperability endpoints

  • Direct secure messaging: sloredo485393@direct.sw.org

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.

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1316782964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 MINT HILL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761082198",
            "telephone_number": "817-718-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-926-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOREDO",
        "first_name": "SAMANTHA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1169639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.