Individual provider Active NPI

Robin Moreno, R.N., A.C.A.G.N.P.

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1366844987
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP126489 Issued in TX
Practice address
221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312
Phone
(214) 960-5681
NPI assigned
Sep 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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 AP126489 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312

Mailing address

PO Box 50268
Denton, TX 76206-0268
Phone (940) 484-1500

Other practice location 1

3120 Medpark Dr
Suite 150
Denton, TX 76208-6981
Phone (940) 484-1500

Other names 1

  • Mrs. Robin Gannon Former name

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
I20141230000496 TX Practitioner - Nurse Practitioner 6800119702 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP126489TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DFW Critical Care LLC CurrentSince Dec 14, 2016 Accepting new patients
Dallas Pulmonary & Critical Care PA Acute Care CurrentSince Feb 15, 2019 Accepting new patients

Locations

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

1001 College Ave
Ste A
Ft Worth, TX 76104
Phone (817) 336-1852

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

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

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": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1366844987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50268",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762060268",
            "telephone_number": "940-484-1500",
            "fax_number": "940-484-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD STE 525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082312",
            "telephone_number": "214-960-5681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 Medpark Dr",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762086981",
            "country_code": "US",
            "telephone_number": "940-484-1500",
            "fax_number": "940-484-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ROBIN",
        "credential": "R.N., A.C.A.G.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP126489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "GANNON",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.