NPIMap

Organization Active NPI

Dallas County Hospital District

Doing business as WISH Campus

  • Women's Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1508014895
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
Legal business name
DALLAS COUNTY HOSPITAL DISTRICT
Doing business as
WISH Campus
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8383
NPI assigned
Aug 29, 2008
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Dr. Frederick P. Cerise, M.D.
Title
President/Chief Executive Officer
Phone
(214) 590-8006

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Neonatal Nurse Practitioner 363LN0000X NU
Pediatric Nurse Practitioner 363LP0200X NU
Women's Health Nurse Practitioner 363LW0102X NU Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 1

IdentifierTypeStateIssuer
195175801MedicaidTX

Other names 1

  • WISH Campus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000583 TX Part B Supplier - Clinic/Group Practice 8325934813 Receives reassigned benefits from 932 practitioners
44 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dallas, TX; Irving, TX; Grand Prairie, TX; Garland, TX; Farmers Branch, TX

Other NPIs on the same Medicare enrollment 42

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 42

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1508014895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "CERISE",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-590-8006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195175801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WISH Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.