Individual provider Active NPI

Marissa Renteria Clavette, CPNP-PC

  • Pediatric Oncology Registered Nurse
  • Fort Worth, TX
National Provider Identifier
1477462307
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Oncology Registered NurseTaxonomy code 163WP0218X
License
831909 Issued in TX
Practice address
1500 Cooper St
Fort Worth, TX 76104-2710
Phone
(682) 885-4000
NPI assigned
Sep 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Oncology Registered Nurse 163WP0218X 831909 TX Primary

Addresses

Primary practice location

1500 Cooper St
Fort Worth, TX 76104-2710

Mailing address

11713 Aldermoor CT
Crowley, TX 76036-3278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1477462307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11713 ALDERMOOR CT",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760363278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042710",
            "telephone_number": "682-885-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVETTE",
        "first_name": "MARISSA",
        "middle_name": "RENTERIA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "TX",
            "license": "831909",
            "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 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.