Individual provider Active NPI

Nicole Kozak Vu, RN, CPNP-AC

  • Critical Care Pediatric Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1740359512
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
AP115114 Issued in TX
Practice address
7777 Forest LN Ste C300J
Dallas, TX 75230-2604
Phone
(972) 566-2043
Fax
(972) 566-7437
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 734058 TX
Nurse Practitioner 363L00000X AP115114 TX
Critical Care Pediatric Nurse Practitioner 363LP0222X AP115114 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste C300J
Dallas, TX 75230-2604

Mailing address

7777 Forest LN Ste C300J
Dallas, TX 75230-2604
Phone (972) 566-2043

Other practice location 1

7777 Forest Ln
Suite B-246
Dallas, TX 75230-2571
Phone (972) 566-7730

Other names 1

  • Nicole Vu Other name

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
I20150331000238 TX Practitioner - Nurse Practitioner 5799002887 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
734058TXMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: nicole.kozakvu@hca7.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1740359512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C300J",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302604",
            "telephone_number": "972-566-2043",
            "fax_number": "972-566-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C300J",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302604",
            "telephone_number": "972-566-2043",
            "fax_number": "972-566-7437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Forest Ln",
            "address_2": "Suite B-246",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752302571",
            "country_code": "US",
            "telephone_number": "972-566-7730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZAK VU",
        "first_name": "NICOLE",
        "credential": "RN, CPNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "734058",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP115114",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "TX",
            "license": "AP115114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "VU",
            "credential": "RN, CPNP-AC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.