Individual provider Active NPI

Shanti S Nagireddy, MD

  • Child & Adolescent Psychiatry Physician
  • Fort Worth, TX
National Provider Identifier
1477646560
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
M3039 Issued in TX
Practice address
901 7TH Ave Ste 2200
Fort Worth, TX 76104-2722
Phone
(682) 885-1050
Fax
(682) 885-7572
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X M3039 TX Primary

Addresses

Primary practice location

901 7TH Ave Ste 2200
Fort Worth, TX 76104-2722

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address snagireddy15819@CookChildrens.direct-ci.com
Direct Messaging Address snagireddy15819@CookChildrens.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070209000559 TX Practitioner - PsychiatryPractitioner - Pediatric Medicine 9133121783 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network CurrentSince Apr 27, 2009 Accepting new patients
Cook Children'S Physician Network CurrentSince Apr 27, 2009 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

1300 S University Dr
Ste 200
Fort Worth, TX 76107
Phone (682) 885-1050

901 7th Ave
Ste 2200
Fort Worth, TX 76104
Phone (682) 885-1050

901 7th Ave
Ft Worth, TX 76104
Phone (682) 885-1050

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1522 Cooper St
Ft Worth, TX 76104
Phone (682) 885-1050

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: snagireddy15819@cookchildrens.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1477646560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 7TH AVE STE 2200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042722",
            "telephone_number": "682-885-1050",
            "fax_number": "682-885-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGIREDDY",
        "first_name": "SHANTI",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "M3039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snagireddy15819@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1300 S University Dr",
            "address_2": "STE 200",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761075737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snagireddy15819@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "901 7th Ave Ste 2200",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.