Individual provider Active NPI

Charity Markham Gates, MSN, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Saginaw, TX
National Provider Identifier
1679178339
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1005236 Issued in TX
Practice address
604 E Bailey Boswell Rd Ste 140
Saginaw, TX 76131-3568
Phone
(817) 484-6610
Fax
(817) 570-0181
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1005236 TX Primary

Addresses

Primary practice location

604 E Bailey Boswell Rd Ste 140
Saginaw, TX 76131-3568

Mailing address

12381 Indian Creek Dr
Fort Worth, TX 76179-6640
Phone (817) 688-0866

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1005236TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. PastSince Dec 6, 2020 Accepting new patients
Samuel H. Davis MD PA PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 2

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": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1679178339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12381 INDIAN CREEK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761796640",
            "telephone_number": "817-688-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E BAILEY BOSWELL RD STE 140",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761313568",
            "telephone_number": "817-484-6610",
            "fax_number": "817-570-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "CHARITY",
        "middle_name": "MARKHAM",
        "credential": "MSN, APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1005236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.