Individual provider Active NPI

Anjelica Dodson

  • Family Nurse Practitioner
  • Prosper, TX
National Provider Identifier
1689287369
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1017669 Issued in TX
Practice address
301 N Preston Rd Ste B
Prosper, TX 75078-8876
Phone
(972) 347-1320
Fax
(972) 347-1322
NPI assigned
Aug 24, 2020
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1017669 TX Primary

Addresses

Primary practice location

301 N Preston Rd Ste B
Prosper, TX 75078-8876

Mailing address

301 N Preston Rd Ste B
Prosper, TX 75078-8876
Phone (972) 347-1320

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211008000858 TX Practitioner - Nurse Practitioner 8022416825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henson ClinicGroup PAC ID 9436322724, 5 clinicians

Practice addresses (Care Compare)

301 N Preston Rd
Suite B
Prosper, TX 75078-8876
Phone (972) 347-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1017669TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henson Clinic CurrentSince Jun 23, 2021 Accepting new patients

Locations

301 N Preston Rd
Ste B
Prosper, TX 75078

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, 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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1689287369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N PRESTON RD STE B",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750788876",
            "telephone_number": "972-347-1320",
            "fax_number": "972-347-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PRESTON RD STE B",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750788876",
            "telephone_number": "972-347-1320",
            "fax_number": "972-347-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "ANJELICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1017669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.