Individual provider Active NPI

Denise Lynne Bredow, R.N., C.F.N.P.

  • Nurse Practitioner
  • Bedford, TX
National Provider Identifier
1619915766
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
557609 Issued in TX
Practice address
1615 Hospital Pkwy
Suite 103
Bedford, TX 76022-5934
Phone
(817) 684-5006
Fax
(817) 684-5042
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 557609 TX Primary

Addresses

Primary practice location

1615 Hospital Pkwy
Suite 103
Bedford, TX 76022-5934

Mailing address

9003 Airport Fwy
Suite 300
North Richland Hills, TX 76180-7770
Phone (817) 514-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: denise.bredow.1@19934.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1619915766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 AIRPORT FWY",
            "address_2": "SUITE 300",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807770",
            "telephone_number": "817-514-5200",
            "fax_number": "817-514-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY",
            "address_2": "SUITE 103",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225934",
            "telephone_number": "817-684-5006",
            "fax_number": "817-684-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDOW",
        "first_name": "DENISE",
        "middle_name": "LYNNE",
        "credential": "R.N., C.F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "557609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.