Active NPI
Dolly K. Chaffin, NP
- Acute Care Nurse Practitioner
- Fort Worth, TX
National Provider Identifier
1669775425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- AP119369
- Practice address
- 1325 Pennsylvania Ave Ste 450
Fort Worth, TX 76104-2191 - Phone
- (817) 250-7240
- Fax
- (888) 977-1985
- NPI assigned
- Dec 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 563286 | TX | |
| Acute Care Nurse Practitioner | 363LA2100X | AP119369 | TX | Primary |
Addresses
Primary practice location
1325 Pennsylvania Ave Ste 450
Fort Worth, TX 76104-2191
Mailing address
1325 Pennsylvania Ave Ste 450
Fort Worth, TX 76104-2191
Phone (817) 250-7240
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP119369 | TX | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alamo City Medical Group, PLLC | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- San Antonio, TX
- NPI 1558354092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1669775425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 PENNSYLVANIA AVE STE 450",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042191",
"telephone_number": "817-250-7240",
"fax_number": "888-977-1985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 PENNSYLVANIA AVE STE 450",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042191",
"telephone_number": "817-250-7240",
"fax_number": "888-977-1985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAFFIN",
"first_name": "DOLLY",
"middle_name": "K.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-15",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "563286",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TX",
"license": "AP119369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.