Individual provider Active NPI

Chelsea Eide, NP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1477094811
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133477 Issued in TX
Practice address
6464 John Ryan Dr
Fort Worth, TX 76132-4239
Phone
(817) 276-8063
Fax
(817) 346-7703
NPI assigned
Mar 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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 AP133477 TX Primary

Addresses

Primary practice location

6464 John Ryan Dr
Fort Worth, TX 76132-4239

Mailing address

6464 John Ryan Dr
Fort Worth, TX 76132-4239

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP133477TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of North Texas - Southeast Health Services PastSince Sep 6, 2020 Accepting new patients
Planned Parenthood of Greater Texas PastSince Sep 6, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: chelsea.eide.p1@direct.ppgt.nextgenshare.com

Organizations & group practices 2

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": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1477094811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6464 JOHN RYAN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324239",
            "telephone_number": "817-276-8063",
            "fax_number": "817-346-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDE",
        "first_name": "CHELSEA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133477",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 27, 2023; 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.