Individual provider Active NPI

Kidest Mezgebe Gebreamanuel, AGACNP

  • Acute Care Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1689365785
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1113114 Issued in TX
Practice address
701 S Nedderman Dr
Arlington, TX 76019-1800
Phone
(817) 272-2011
NPI assigned
May 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1113114 TX Primary

Addresses

Primary practice location

701 S Nedderman Dr
Arlington, TX 76019-1800

Mailing address

701 S Nedderman Dr
Arlington, TX 76019-9800
Phone (817) 272-2011

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
I20231030001676 TX Practitioner - Nurse Practitioner 0941656854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Medical Specialists, PLLCGroup PAC ID 3072895788, 86 clinicians

Practice addresses (Care Compare)

3301 Matlock Rd
Arlington, TX 76015-2908
Phone (682) 509-6200

Hospital & facility affiliations

  • Medical City Arlington Hospital, Arlington, TX, CCN 450675

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1113114TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Medical Specialists, PLLC CurrentSince Oct 1, 2024 Accepting new patients
Medhealth CurrentSince Oct 2, 2023 Accepting new patients
Medhealth CurrentSince Oct 2, 2023 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3301 Matlock Rd
Arlington, TX 76015
Phone (682) 509-6200

7777 Forest Ln
Ste C300
Dallas, TX 75230
Phone (972) 566-6000

900 Jerome St
Ste 204
Fort Worth, TX 76104
Phone (817) 885-7827

1308 Paluxy Rd
Ste 205
Granbury, TX 76048
Phone (817) 489-7450

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

2800 E Broad St
Ste 504
Mansfield, TX 76063
Phone (817) 225-0410

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1689365785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S NEDDERMAN DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760199800",
            "telephone_number": "817-272-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S NEDDERMAN DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760191800",
            "telephone_number": "817-272-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREAMANUEL",
        "first_name": "KIDEST",
        "middle_name": "MEZGEBE",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1113114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.