Individual provider Active NPI

Kathy Adrianne Cook Porter, NP

  • Women's Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1568465136
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP111291 Issued in TX
Practice address
3450 W Wheatland Rd Ste 440
Dallas, TX 75237-4417
Phone
(972) 298-4300
Fax
(972) 298-8903
NPI assigned
May 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP111291 TX Primary

Addresses

Primary practice location

3450 W Wheatland Rd Ste 440
Dallas, TX 75237-4417

Mailing address

3450 W Wheatland Rd Ste 440
Dallas, TX 75237-4417
Phone (972) 298-4300

Other practice location 1

400 E. Jefferson
Waxahachie, TX 75165
Phone (972) 923-2440

Other identifiers 1

IdentifierTypeStateIssuer
1479685MedicaidTX

Other names 1

  • Kathy C Cook Other name

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
I20050426001124 TX Practitioner - Nurse Practitioner 3274572649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

3450 W Wheatland Rd
Pob II Suite 440
Dallas, TX 75237-4417
Phone (972) 296-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP111291TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Apr 5, 2024 Accepting new patients
Medhealth CurrentSince Apr 5, 2024 Accepting new patients
F. Thomas Dean, M. D. Current Accepting new patients
Omega OB-GYN Associates of South Arlington Past Accepting new patients

Locations

3450 W Wheatland Rd
Ste 440
Dallas, TX 75237
Phone (972) 224-1122

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

Interoperability endpoints

  • Direct secure messaging: kathy.cookporter@tx123.digichart.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/20865/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1568465136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 W WHEATLAND RD STE 440",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752374417",
            "telephone_number": "972-298-4300",
            "fax_number": "972-298-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W WHEATLAND RD STE 440",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752374417",
            "telephone_number": "972-298-4300",
            "fax_number": "972-298-8903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E. Jefferson",
            "address_purpose": "LOCATION",
            "city": "Waxahachie",
            "state": "TX",
            "postal_code": "75165",
            "country_code": "US",
            "telephone_number": "972-923-2440",
            "fax_number": "972-923-2445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK PORTER",
        "first_name": "KATHY",
        "middle_name": "ADRIANNE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "AP111291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1479685",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "COOK",
            "middle_name": "C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.