Individual provider Active NPI

Carol J Hedtke, NP

  • Family Nurse Practitioner
  • Denton, TX
National Provider Identifier
1417999848
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
675701 Issued in TX
Practice address
2535 Charlotte St
Suite 102
Denton, TX 76201-3301
Phone
(940) 387-7300
Fax
(940) 387-1848
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 675701 TX Primary

Addresses

Primary practice location

2535 Charlotte St
Suite 102
Denton, TX 76201-3301

Mailing address

2535 Charlotte St
Suite 102
Denton, TX 76201-3301
Phone (940) 387-7300

Other identifiers 3

IdentifierTypeStateIssuer
IN PROCESSMedicaidTX
TX135420OtherTXMEDICARE GROUP PTAN
TX135423OtherTXMEDICARE INDIVIDUAL PTAN

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
I20060803000267 TX Practitioner - Nurse Practitioner 2062425317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2535 Charlotte St
Suite 102
Denton, TX 76201-3302
Phone (940) 347-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
675701TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avere Healthcare Clinics LLC Family CurrentSince Jul 5, 2011 Accepting new patients
Avere Healthcare Clinics LLC Family Current Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Locations

2535 Charlotte St
Ste 102
Denton, TX 76201
Phone (940) 347-7300

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1417999848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 CHARLOTTE ST",
            "address_2": "SUITE 102",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013301",
            "telephone_number": "940-387-7300",
            "fax_number": "940-387-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 CHARLOTTE ST",
            "address_2": "SUITE 102",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762013301",
            "telephone_number": "940-387-7300",
            "fax_number": "940-387-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDTKE",
        "first_name": "CAROL",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "675701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IN PROCESS",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "TX135420",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "TX135423",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.