Individual provider Active NPI

Katelyn Weatherford, APRN

  • Acute Care Nurse Practitioner
  • Plano, TX
National Provider Identifier
1376158279
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP1012352 Issued in TX
Practice address
6124 W Parker Rd Ste 530
Plano, TX 75093-8140
Phone
(214) 778-1075
NPI assigned
Sep 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN876768 TX
Gerontology Nurse Practitioner 363LG0600X AP1012352 TX
Acute Care Nurse Practitioner 363LA2100X AP1012352 TX Primary

Addresses

Primary practice location

6124 W Parker Rd Ste 530
Plano, TX 75093-8140

Mailing address

6124 W Parker Rd Ste 530
Plano, TX 75093-8140
Phone (214) 778-1075

Other identifiers 2

IdentifierTypeStateIssuer
AP1012352OtherTXLICENSE
RN876768OtherTXLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A Other

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
I20201014003751 TX Practitioner - Nurse Practitioner 0244650158 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN876768TXMDCritical Care Medicine Registered Nurse
AP1012352TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 24, 2022 Accepting new patients
Cogent Healthcare of Texas, PA CurrentSince Mar 9, 2021 Accepting new patients
Peterson Wellness Primary Care and Pediatrics, PLLC Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Oct 24, 2022 Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

8220 Walnut Hill Ln
Ste 408
Dallas, TX 75231
Phone (214) 361-9777

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

6124 W Parker Rd
Ste 530
Plano, TX 75093
Phone (214) 778-1075

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24551/brand/1/csg/1/fhir/r4
  • Direct secure messaging: katelyn.weatherford.1@24551.direct.athenahealth.com

Organizations & group practices 4

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": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1376158279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6124 W PARKER RD STE 530",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938140",
            "telephone_number": "214-778-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 W PARKER RD STE 530",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938140",
            "telephone_number": "214-778-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERFORD",
        "first_name": "KATELYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "RN876768",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP1012352",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP1012352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP1012352",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN876768",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "6124 W Parker Rd Ste 530",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750938140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.