NPIMap

Organization Active NPI

Equilyst LLC.

Doing business as Equilyst Modern Medicine

  • Clinic/Center
  • Dallas, TX
National Provider Identifier
1679123632
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EQUILYST LLC.
Doing business as
Equilyst Modern Medicine
Practice address
2909 Canton St Ste C
Dallas, TX 75226-3508
Phone
(214) 984-3696
Fax
(469) 523-5503
NPI assigned
Sep 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Mr. William Blake York, FNP-CNPI 1326531609
Title
Managing Member
Phone
(337) 580-0710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2909 Canton St Ste C
Dallas, TX 75226-3508

Mailing address

3131 Main St Apt 122
Dallas, TX 75226-1530
Phone (337) 580-0710

Other names 1

  • EQUILYST MODERN MEDICINE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://equilystemr.md-hq.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

2909 Canton St
Ste C
Dallas, TX 75226
Phone (214) 984-3696

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1679123632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 MAIN ST APT 122",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261530",
            "telephone_number": "337-580-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 CANTON ST STE C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752263508",
            "telephone_number": "214-984-3696",
            "fax_number": "469-523-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILYST LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "337-580-0710",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://equilystemr.md-hq.com",
            "affiliation": "N",
            "endpointDescription": "Equilyst EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2909 Canton St Ste C",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752263508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "EQUILYST MODERN MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.

Verify at the official NPI Registry.