NPIMap

Individual provider Active NPI

Denise Carol Anderson, C.D.E.

  • Registered Dietitian
  • Fort Worth, TX
National Provider Identifier
1457531493
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
319222 Issued in MI
Practice address
800 5TH Ave
Suite 300
Fort Worth, TX 76104-7300
Phone
(817) 334-1400
Fax
(817) 334-1410
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 319222 MI Primary

Addresses

Primary practice location

800 5TH Ave
Suite 300
Fort Worth, TX 76104-7300

Mailing address

9003 Airport Fwy
Suite 300
North Richland Hills, TX 76180-7770
Phone (817) 514-5200

Other identifiers 4

IdentifierTypeStateIssuer
ON53610OtherMIMEDICARE NUMBER, MICHIGAN
8K2932OtherTXMEDICARE ID, UNSPECIFIED
8K2934OtherTXMEDICARE ID, UNSPECIFIED
8K2933OtherTXMEDICARE ID, UNSPECIFIED

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

State licenses

LicenseStateTypeSpecialty
319222MIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Botsford General Hospital Past Accepting new patients
Impel Management Services, LLC Past Accepting new patients
Medical Clinic of North Texas PLLC Past Accepting new patients
Impel Management Services, LLC Dietitian, Registered Past Accepting new patients
Botsford General Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1457531493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 AIRPORT FWY",
            "address_2": "SUITE 300",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807770",
            "telephone_number": "817-514-5200",
            "fax_number": "817-514-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE",
            "address_2": "SUITE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047300",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DENISE",
        "middle_name": "CAROL",
        "credential": "C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "319222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER, MICHIGAN",
            "identifier": "ON53610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID, UNSPECIFIED",
            "identifier": "8K2932",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID, UNSPECIFIED",
            "identifier": "8K2934",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID, UNSPECIFIED",
            "identifier": "8K2933",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "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 Mar 17, 2009; 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.