Individual provider Active NPI

Daniel Petrie, APRN

  • Family Nurse Practitioner
  • Lewisville, TX
National Provider Identifier
1649858705
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1030522 Issued in TX
Practice address
2403 S Stemmons Fwy Ste 105
Lewisville, TX 75067-2314
Phone
(972) 829-6206
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 1030522 TX Primary

Addresses

Primary practice location

2403 S Stemmons Fwy Ste 105
Lewisville, TX 75067-2314

Mailing address

2403 S Stemmons Fwy Ste 105
Lewisville, TX 75067-2314
Phone (972) 829-6206

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1030522TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Testerone Centers of Texas, PLLC CurrentSince Jul 31, 2022 Accepting new patients

Locations

2403 S Stemmons Fwy
Ste 105
Lewisville, TX 75067
Phone (972) 829-6206

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1649858705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 S STEMMONS FWY STE 105",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750672314",
            "telephone_number": "972-829-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 S STEMMONS FWY STE 105",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750672314",
            "telephone_number": "972-829-6206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "DANIEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1030522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.