Individual provider Active NPI

Nadine Terrazas Rose, MD

  • Pediatrics Physician
  • Stephenville, TX
National Provider Identifier
1538365655
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P0125 Issued in TX
Practice address
205 E Frey St Unit 101
Stephenville, TX 76401-2609
Phone
(254) 918-2484
Fax
(254) 965-3294
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25673 OK
Pediatrics Physician 208000000X P0125 TX Primary

Addresses

Primary practice location

205 E Frey St Unit 101
Stephenville, TX 76401-2609

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1860

Other names 1

  • Nadine Terrazas Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nrose110418@CookChildrens.direct-ci.com
Direct Messaging Address nrose110418@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
I20111019000128 TX Practitioner - Pediatric Medicine 3375676695 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 Pediatrics CurrentSince Mar 19, 2020 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Mar 19, 2020 Accepting new patients
Cook Children's Medical Center PastSince May 9, 2021 Accepting new patients

Locations

1500 W Rosedale St
Fort Worth, TX 76104
Phone (682) 885-3426

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

205 E Frey St
Unit 101
Stephenville, TX 76401
Phone (254) 918-2484

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

Interoperability endpoints

  • Direct secure messaging: nrose110418@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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1538365655",
    "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": "682-885-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E FREY ST UNIT 101",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012609",
            "telephone_number": "254-918-2484",
            "fax_number": "254-965-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "NADINE",
        "middle_name": "TERRAZAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "25673",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P0125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrose110418@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrose110418@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "205 E Frey St Unit 101",
            "city": "Stephenville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "764012609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NADINE",
            "last_name": "TERRAZAS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stephenville, TX

Sources for this page

Verify at the official NPI Registry.