Individual provider Active NPI

Nicole Renee Pitts, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Prosper, TX
National Provider Identifier
1629426028
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
S9777 Issued in TX
Practice address
4200 W University Dr FL 2
Prosper, TX 75078-9805
Phone
(682) 303-4200
Fax
(682) 303-4242
NPI assigned
May 26, 2016
Last updated
May 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT017151 PA
Sports Medicine (Family Medicine) Physician 207QS0010X OS16539 FL
Sports Medicine (Family Medicine) Physician 207QS0010X S9777 TX Primary

Addresses

Primary practice location

4200 W University Dr FL 2
Prosper, TX 75078-9805

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address npitts166471@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201001000177 FL Practitioner - Family Practice 0244527562 Reassigns benefits to 5 organizations
I20210407002274 TX Practitioner - Sports Medicine 0244527562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
West Boynton Urgent Care, LLC CurrentSince Mar 27, 2021 Accepting new patients
Cook Children's Physician Network CurrentSince May 24, 2021 Accepting new patients
Carespot of Orlando Hsi Urgent Care LLC CurrentSince Aug 21, 2020 Accepting new patients
Shands/Solantic Joint Venture, LLC CurrentSince Aug 21, 2020 Accepting new patients
Hma/Solantic Joint Venture, LLC CurrentSince Mar 27, 2021 Accepting new patients
Cook Children's Physician Network CurrentSince May 24, 2021 Accepting new patients
Solantic/South Florida, LLC CurrentSince Mar 27, 2021 Accepting new patients

Locations

3840 State Road 436
Ste 1
Apopka, FL 32703
Phone (407) 478-3202

8756 Boynton Rd W
Ste 150
Boynton Beach, FL 33472
Phone (561) 740-2273

720 SW 2nd Ave
Ste 160A
Gainesville, FL 32601
Phone (352) 240-8000

18706 NW 67th Ave
Miami Gardens, FL 33015
Phone (786) 563-0280

2415 SW College Rd
Ocala, FL 34471
Phone (352) 237-3536

10959 W Colonial Dr
Ste 6
Ocoee, FL 34761
Phone (407) 554-4590

18203 Pines Blvd
Pembroke Pines, FL 33029
Phone (954) 889-5823

9035 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 340-5881

129 S State Road 7
Ste 401
Royal Palm Beach, FL 33414
Phone (561) 425-7801

10251 W Commercial Blvd
Sunrise, FL 33351
Phone (951) 580-4100

1820 58th Ave
Ste 110
Vero Beach, FL 32966
Phone (772) 257-3200

115 Eastpark Dr
Ste 300
Brentwood, TN 37027

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

4200 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

4200 W University Dr
Fl 2
Prosper, TX 75078
Phone (682) 303-4200

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

Interoperability endpoints

  • Direct secure messaging: npitts166471@cookchildrens.direct-ci.com
  • Direct secure messaging: npitts424680@direct.shands.ufl.edu

Organizations & group practices 7

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1629426028",
    "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": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W UNIVERSITY DR FL 2",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789805",
            "telephone_number": "682-303-4200",
            "fax_number": "682-303-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT017151",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS16539",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "S9777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npitts166471@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4200 W University Dr Fl 2",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750789805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.