Individual provider Active NPI

Cherelle Edwards, NP

  • Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1609466226
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1011826 Issued in TX
Practice address
647 N Miller Rd Ste 200
Mansfield, TX 76063-6083
Phone
(817) 415-9680
Fax
(917) 415-9669
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 1011826 TX Primary

Addresses

Primary practice location

647 N Miller Rd Ste 200
Mansfield, TX 76063-6083

Mailing address

8267 Elmbrook Dr Ste 200
Dallas, TX 75247-4078
Phone (214) 424-2200

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
I20230630002622 TX Practitioner - Nurse Practitioner 0648639179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1011826TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Single Specialty CurrentSince Jul 23, 2023 Accepting new patients
Texas Digestive Disease Consultants PLLC Single Specialty CurrentSince Jul 21, 2023 Accepting new patients
Texas Digestive Disease Consultants, PLLC Single Specialty CurrentSince Jul 21, 2023 Accepting new patients

Locations

8267 Elmbrook Dr
Ste 200
Dallas, TX 75247
Phone (512) 485-5889

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

647 N Miller Rd
Ste 200
Mansfield, TX 76063
Phone (817) 415-9680

647 N Miller Rd
Ste B
Mansfield, TX 76063
Phone (817) 760-7969

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": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1609466226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8267 ELMBROOK DR STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474078",
            "telephone_number": "214-424-2200",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 N MILLER RD STE 200",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636083",
            "telephone_number": "817-415-9680",
            "fax_number": "917-415-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CHERELLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1011826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.