Individual provider Active NPI

Debra S McBride Balthrop, CPNP

  • Pediatric Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1437375086
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
501664 Issued in TX
Practice address
1935 Medical District Dr
Dallas, TX 75235-7701
Phone
(972) 303-2100
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 501664 TX Primary
Pediatric Nurse Practitioner 363LP0200X 107882 CO

Addresses

Primary practice location

1935 Medical District Dr
Dallas, TX 75235-7701

Mailing address

4200 Lauren Way
Flower Mound, TX 75028-2938
Phone (214) 469-9852

Other identifiers 1

IdentifierTypeStateIssuer
27555704MedicaidCO

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
I20110314000901 TX Practitioner - Nurse Practitioner 7618942673 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 30, 2024 Accepting new patients
Collin Emergency Medicine Associates PA Past Accepting new patients

Locations

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

Interoperability endpoints

  • Direct secure messaging: dbalthrop328946@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1437375086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 LAUREN WAY",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282938",
            "telephone_number": "214-469-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "972-303-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTHROP",
        "first_name": "DEBRA",
        "middle_name": "S MCBRIDE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "501664",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "107882",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27555704",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.