Active NPI
Katie Hughes Dinnen, PA-C
- Physician Assistant
- Fort Worth, TX
National Provider Identifier
1720535750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12495
- Practice address
- 4601 West Fwy Ste 216
Fort Worth, TX 76107-5491 - Phone
- (817) 377-4603
- NPI assigned
- Sep 7, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12495 | TX | Primary |
| Physician Assistant | 363A00000X | 6450 | AZ |
Addresses
Primary practice location
4601 West Fwy Ste 216
Fort Worth, TX 76107-5491
Mailing address
4601 West Fwy Ste 216
Fort Worth, TX 76107-5491
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12495 | TX | MD | General Practice Dentistry |
| 6450 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547424000000",
"number": "1720535750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 WEST FWY STE 216",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761075491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 WEST FWY STE 216",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761075491",
"telephone_number": "817-377-4603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINNEN",
"first_name": "KATIE",
"middle_name": "HUGHES",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-07",
"last_updated": "2019-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "12495",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "6450",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.