Individual provider Active NPI

Catherine M Stephens

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1619554664
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F03210688 Issued in TX
Practice address
5925 Convair Dr Ste 509
Fort Worth, TX 76109-1276
Phone
(817) 349-7541
NPI assigned
Mar 25, 2021
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F03210688 TX Primary

Addresses

Primary practice location

5925 Convair Dr Ste 509
Fort Worth, TX 76109-1276

Mailing address

5925 Convair Dr
Ste 509
Fort Worth, TX 76109-1276
Phone (817) 349-7541

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
I20211012000856 TX Practitioner - Nurse Practitioner 4183022726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Integrated Health Clinics, PLLCGroup PAC ID 0749535763, 5 clinicians

Practice addresses (Care Compare)

5925 Convair Dr
Suite 509
Fort Worth, TX 76109-1276
Phone (817) 349-7541

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F03210688TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
White Integrated Health Clinics, PLLC Family CurrentSince Oct 1, 2021 Accepting new patients

Locations

5925 Convair Dr
Ste 509
Fort Worth, TX 76109
Phone (817) 349-7541

1141 Long Ave
River Oaks, TX 76114
Phone (325) 695-2225

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1619554664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 CONVAIR DR",
            "address_2": "STE 509",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091276",
            "telephone_number": "817-349-7541",
            "fax_number": "817-349-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 CONVAIR DR STE 509",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091276",
            "telephone_number": "817-349-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "CATHERINE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2023-06-23",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F03210688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.