Individual provider Active NPI

Caroline Schrader Spalla, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1326425448
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R6681 Issued in TX
Practice address
5708 Edwards Ranch Rd
Fort Worth, TX 76109-4115
Phone
(817) 336-4040
NPI assigned
Apr 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R6681 TX Primary

Addresses

Primary practice location

5708 Edwards Ranch Rd
Fort Worth, TX 76109-4115

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cspalla92859@CookChildrens.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180814001918 TX Practitioner - Pediatric Medicine 2365791001 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 20, 2018 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Aug 20, 2018 Accepting new patients

Locations

5708 Edwards Ranch Rd
Fort Worth, TX 76109
Phone (817) 336-4040

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

Interoperability endpoints

  • Direct secure messaging: cspalla92859@cookchildrens.direct-ci.com

Organizations & group practices 2

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": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1326425448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5708 EDWARDS RANCH RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094115",
            "telephone_number": "817-336-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPALLA",
        "first_name": "CAROLINE",
        "middle_name": "SCHRADER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R6681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cspalla92859@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "5708 Edwards Ranch Rd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761094115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.