Individual provider Active NPI

Elizabeth Ann Yells, CPNP

  • Pediatric Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1346903259
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1055337 Issued in TX
Practice address
1401 W Pulaski St
Fort Worth, TX 76104-2717
Phone
(682) 885-8012
Fax
(682) 885-8014
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1055337 TX Primary

Addresses

Primary practice location

1401 W Pulaski St
Fort Worth, TX 76104-2717

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-1860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eyells139877@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1055337TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cole Clinic, PA PastSince Jun 6, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eyells139877@cookchildrens.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1346903259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "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": "1401 W PULASKI ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042717",
            "telephone_number": "682-885-8012",
            "fax_number": "682-885-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1055337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eyells139877@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1401 W Pulaski St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.