Individual provider Active NPI

Laterica Kanish House

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1730579814
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP127223 Issued in TX
Practice address
13737 Noel Rd
Dallas, TX 75240-1331
Phone
(214) 754-8700
Fax
(214) 239-4311
NPI assigned
Jan 28, 2015
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP127223 TX Primary
Family Nurse Practitioner 363LF0000X 735041 TX

Addresses

Primary practice location

13737 Noel Rd
Dallas, TX 75240-1331

Mailing address

13737 Noel Rd
Dallas, TX 75240-1331
Phone (214) 754-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR, MI, AL, WY5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20150304000613 TX Practitioner - Nurse Practitioner 7012233307 Reassigns benefits to 1 organization
I20200714000879 AR Practitioner - Nurse Practitioner 7012233307 Reassigns benefits to 2 organizations
I20251215001952 MI Practitioner - Nurse Practitioner 7012233307 Reassigns benefits to 1 organization
I20251222002517 AL Practitioner - Nurse Practitioner 7012233307 Reassigns benefits to 1 organization
I20251224001007 WY Practitioner - Nurse Practitioner 7012233307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
735041TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Psych Care of Arkansas PA CurrentSince Nov 29, 2024 Accepting new patients
Virtual Health and Well-Being Nurse Practitioner Current Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Dec 1, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Dec 1, 2025 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

811 W Elgin St
Siloam Springs, AR 72761
Phone (479) 524-3128

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1712 Pioneer Ave
Cheyenne, WY 82001
Phone (307) 222-0371

Organizations & group practices 4

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": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1730579814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "214-754-8700",
            "fax_number": "214-239-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "214-754-8700",
            "fax_number": "214-239-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "LATERICA",
        "middle_name": "KANISH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP127223",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "735041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.