Individual provider Active NPI

Rolla Shbarou, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Amarillo, TX
National Provider Identifier
1578653135
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
S8652 Issued in TX
Practice address
17 Care Cir Ste 100
Amarillo, TX 79124-2105
Phone
(432) 570-5693
Fax
(432) 570-5696
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X E-3816 AR
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X S8652 TX Primary

Addresses

Primary practice location

17 Care Cir Ste 100
Amarillo, TX 79124-2105

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Other practice location 1

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rshbarou160968@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
I20201230002482 TX Practitioner - Pediatric MedicinePractitioner - Neurology 2769432871 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 CurrentSince Jan 4, 2021 Accepting new patients
Cook Children'S Physician Network CurrentSince Jan 4, 2021 Accepting new patients

Locations

17 Care Cir
#100
Amarillo, TX 79124
Phone (432) 570-5693

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

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

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

Interoperability endpoints

  • Direct secure messaging: rshbarou160968@cookchildrens.direct-ci.com

Organizations & group practices 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1578653135",
    "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": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CARE CIR STE 100",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791242105",
            "telephone_number": "432-570-5693",
            "fax_number": "432-570-5696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way # 653",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-6077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHBAROU",
        "first_name": "ROLLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AR",
            "license": "E-3816",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "S8652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshbarou160968@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "17 Care Cir Ste 100",
            "city": "Amarillo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "791242105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.