Individual provider Active NPI

Waldfeld Rios

  • Adult Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1679055750
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP138494 Issued in TX
Practice address
10412 Bear Creek TRL
Fort Worth, TX 76244-6515
Phone
(214) 704-6937
NPI assigned
Sep 5, 2018
Last updated
Mar 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP138494 TX Primary

Addresses

Primary practice location

10412 Bear Creek TRL
Fort Worth, TX 76244-6515

Mailing address

10412 Bear Creek TRL
Fort Worth, TX 76244-6515
Phone (214) 704-6937

Other practice location 1

13747 Montfort Dr Ste 107
Dallas, TX 75240
Phone (972) 233-0525

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

LicenseStateTypeSpecialty
AP138494TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Knights of Comfort Hospice L.L.C. CurrentSince Mar 22, 2020 Accepting new patients
Autumn Journey Hospice, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1679055750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10412 BEAR CREEK TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446515",
            "telephone_number": "214-704-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10412 BEAR CREEK TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446515",
            "telephone_number": "214-704-6937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13747 Montfort Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75240",
            "country_code": "US",
            "telephone_number": "972-233-0525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIOS",
        "first_name": "WALDFELD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-05",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP138494",
            "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 Mar 17, 2020; 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.