Active NPI
Michelle Beatrice Oconnor, CPNP
- Pediatric Nurse Practitioner
- Fort Worth, TX
National Provider Identifier
1770873077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 541137
- Practice address
- 6239 Granbury Rd
Fort Worth, TX 76133-3401 - Phone
- (817) 652-3395
- Fax
- (817) 263-8878
- NPI assigned
- Apr 8, 2011
- 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 | 541137 | TX | Primary |
Addresses
Primary practice location
6239 Granbury Rd
Fort Worth, TX 76133-3401
Mailing address
6239 Granbury Rd
Fort Worth, TX 76133-3401
Phone (817) 652-3395
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 541137 | TX | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302220800000",
"number": "1770873077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6239 GRANBURY RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761333401",
"telephone_number": "817-652-3395",
"fax_number": "817-263-8878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6239 GRANBURY RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761333401",
"telephone_number": "817-652-3395",
"fax_number": "817-263-8878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OCONNOR",
"first_name": "MICHELLE",
"middle_name": "BEATRICE",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-08",
"last_updated": "2011-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "541137",
"primary": true
}
],
"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 Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.