Active NPI
Mary Jane Haskew, NP
- Pediatric Nurse Practitioner
- Lewisville, TX
National Provider Identifier
1689688756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 545514
- Practice address
- 502 S Old Orchard LN
Suite 126
Lewisville, TX 75067-4374 - Phone
- (972) 436-7962
- Fax
- (972) 353-5780
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 545514 | TX | Primary |
Addresses
Primary practice location
502 S Old Orchard LN
Suite 126
Lewisville, TX 75067-4374
Mailing address
502 S Old Orchard LN
Suite 126
Lewisville, TX 75067-4374
Phone (972) 436-7962
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 153212903 | Medicaid | TX | |
| 545514 | Other | TX | NURSE PRACTITIONERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 545514 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediplace | Pediatrics | Current | Accepting new patients |
| Pediplace | Pediatrics | Current | Accepting new patients |
| Acs Primary Care Physicians Southwest, PA | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- mhaskew@pplacetx.pcc-direct.com
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.
-
- Emergency Medicine Physician
- Gainesville, TX
- NPI 1538101019
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1689688756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 S OLD ORCHARD LN",
"address_2": "SUITE 126",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750674374",
"telephone_number": "972-436-7962",
"fax_number": "972-353-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 S OLD ORCHARD LN",
"address_2": "SUITE 126",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750674374",
"telephone_number": "972-436-7962",
"fax_number": "972-353-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASKEW",
"first_name": "MARY",
"middle_name": "JANE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "545514",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "153212903",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSE PRACTITIONERS",
"identifier": "545514",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.