Individual provider Active NPI

Julie Podiyamma John

  • Acute Care Nurse Practitioner
  • Rockwall, TX
National Provider Identifier
1740024827
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1143002 Issued in TX
Practice address
3142 Horizon Rd Ste 110
Rockwall, TX 75032-7810
Phone
(972) 771-1171
NPI assigned
Jun 24, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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 1143002 TX Primary

Addresses

Primary practice location

3142 Horizon Rd Ste 110
Rockwall, TX 75032-7810

Mailing address

5210 Saint Charles Dr
Rowlett, TX 75088-6191
Phone (469) 497-9752

Other practice location 1

5210 Saint Charles Dr
Rowlett, TX 75088-6191
Phone (469) 497-9752

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
I20240821005030 TX Practitioner - Nurse Practitioner 1557800547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

3142 Horizon Rd
Suite 110
Rockwall, TX 75032-7810
Phone (972) 771-1171

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1143002TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2024 Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2024 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

3142 Horizon Rd
Ste 110
Rockwall, TX 75032
Phone (972) 771-1171

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • Direct secure messaging: jjohn2559520@direct.texashealth.org

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.

Hospital & facility affiliations 10

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1740024827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 SAINT CHARLES DR",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750886191",
            "telephone_number": "469-497-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD STE 110",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327810",
            "telephone_number": "972-771-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5210 Saint Charles Dr",
            "address_purpose": "LOCATION",
            "city": "Rowlett",
            "state": "TX",
            "postal_code": "750886191",
            "country_code": "US",
            "telephone_number": "469-497-9752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JULIE",
        "middle_name": "PODIYAMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1143002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.