Individual provider Active NPI

Stephanie Lynn Vandendyck, APRN, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1487520144
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1052059 Issued in TX
Practice address
3520 NW Centre Dr
Fort Worth, TX 76135-3612
Phone
(817) 375-2100
NPI assigned
Oct 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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 1052059 TX Primary

Addresses

Primary practice location

3520 NW Centre Dr
Fort Worth, TX 76135-3612

Mailing address

205 Valley View Dr S
Colleyville, TX 76034-3208
Phone (682) 551-5006

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
I20260526000672 TX Practitioner - Nurse Practitioner 7012487655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

3520 NW Centre Dr
Fort Worth, TX 76135-3612
Phone (817) 375-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1052059TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Physicians, PLLC CurrentSince Jun 15, 2026 Accepting new patients

Locations

3520 NW Centre Dr
Lake Worth, TX 76135
Phone (817) 375-2100

Organizations & group practices 1

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": "1760054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1487520144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 VALLEY VIEW DR S",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760343208",
            "telephone_number": "682-551-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 NW CENTRE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761353612",
            "telephone_number": "817-375-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENDYCK",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-10",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1052059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.