Individual provider Active NPI

Phyllis Adams

  • Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1508835380
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
420156 Issued in TX
Practice address
701 E Arbrook Blvd Ste a
Arlington, TX 76014-3240
Phone
(682) 867-1500
Fax
(817) 419-1129
NPI assigned
Mar 15, 2006
Last updated
Jun 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 420156 TX Primary

Addresses

Primary practice location

701 E Arbrook Blvd Ste a
Arlington, TX 76014-3240

Mailing address

1225 Chinkapin PL
Flower Mound, TX 75028-3229
Phone (972) 724-2009

Other identifiers 1

IdentifierTypeStateIssuer
44385503MedicaidTX

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
420156TXMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1508835380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CHINKAPIN PL",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283229",
            "telephone_number": "972-724-2009",
            "fax_number": "817-272-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E ARBROOK BLVD STE A",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143240",
            "telephone_number": "682-867-1500",
            "fax_number": "817-419-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "PHYLLIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "420156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44385503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.