Katie Colleen Pedicord, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA04430 Issued in TX

Practice address

8230 Walnut Hill LN
Suite 808
Dallas, TX 75231-4482

Phone

(214) 696-8828

Fax

(214) 696-1444

NPI assigned

Aug 28, 2006

Last updated

Aug 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Katie Colleen Rose Former name

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

Specialty

Physician Assistant

Education

University of Oklahoma College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thornwell H Parker III M D P aGroup PAC ID 4284733692, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Thornwell H Parker III M D P a

  • Plastic and Reconstructive Surgery Physician
  • Dallas, TX
  • NPI 1215138599
  Medicare reassignment Care Compare group
• Forrest C. Brown MD,PA

  dba Consulting Dermatologic Specialists

  • Specialist
  • Dallas, TX
  • NPI 1205024734
  NPD (past)
• North Texas Spinecare, LLP

  • Orthopaedic Surgery of the Spine Physician
  • Dallas, TX
  • NPI 1245377555
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1659489920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 WALNUT HILL LN",
            "address_2": "SUITE 808",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314482",
            "telephone_number": "214-696-8828",
            "fax_number": "214-696-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 WALNUT HILL LN",
            "address_2": "SUITE 808",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314482",
            "telephone_number": "214-696-8828",
            "fax_number": "214-696-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDICORD",
        "first_name": "KATIE",
        "middle_name": "COLLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04430",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA04430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "ROSE",
            "middle_name": "COLLEEN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pediatricians of Dallas, PA (Pediatricians of Dallas)
• Pediatrics of Dallas
• Pediatrics Primary Care Clinic (PPCC)
• Pediatrix Medical Group of Texas Billing, Inc.
• Pediatrix Primary Care of Texas PLLC
• Pediplace
• Pedro a. Cruz ,M.D.,P.a.
• Pedro P Hani, MD, PA
• Annaleigh Michelle Pedroza, NNP-BC
• Estrella Pedroza, PA-C

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.