Individual provider Active NPI

Jamie Carol Dark, RN, MSN, CPNP

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1780993162
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
734374 Issued in TX
Practice address
12174 N Mopac Expy
Ste. a
Austin, TX 78758-2910
Phone
(512) 833-7334
Fax
(512) 833-7333
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 734374 TX Primary

Addresses

Primary practice location

12174 N Mopac Expy
Ste. a
Austin, TX 78758-2910

Mailing address

12174 N Mopac Expy
Ste. a
Austin, TX 78758-2910
Phone (512) 833-7334

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
734374TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TCH Pediatric Associates, Inc Past Accepting new patients

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": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1780993162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12174 N MOPAC EXPY",
            "address_2": "STE. A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582910",
            "telephone_number": "512-833-7334",
            "fax_number": "512-833-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12174 N MOPAC EXPY",
            "address_2": "STE. A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582910",
            "telephone_number": "512-833-7334",
            "fax_number": "512-833-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARK",
        "first_name": "JAMIE",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "734374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.