Organization Active NPI

J. Gabrielle P. Patterson M.D., P.a.

  • Internal Medicine Physician
  • Richardson, TX
National Provider Identifier
1801170816
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K5653 Issued in TX
Legal business name
J. GABRIELLE P. PATTERSON M.D., P.A.
Practice address
403 W Campbell Rd Ste 410
Richardson, TX 75080-3466
Phone
(972) 498-8670
Fax
(972) 498-8676
NPI assigned
Oct 10, 2011
Last updated
Oct 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Authorized official

Name
Dr. Jennifer Gabrielle Patterson, MD
Title
Owner/MD
Phone
(972) 498-8670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K5653 TX Primary

Addresses

Primary practice location

403 W Campbell Rd Ste 410
Richardson, TX 75080-3466

Mailing address

403 W Campbell Rd Ste 410
Richardson, TX 75080-3466
Phone (972) 498-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120206000623 TX Part B Supplier - Clinic/Group Practice 0749447597 Receives reassigned benefits from 1 practitioner
Practice locations: Richardson, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1045353J Gabrielle P Patterson MD PA403 W Campbell Road Suite 410, Richardson, TX 75080Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory

Locations

403 W Campbell Rd
Ste 410
Richardson, TX 75080
Phone (972) 498-8670

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1801170816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W CAMPBELL RD STE 410",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803466",
            "telephone_number": "972-498-8670",
            "fax_number": "972-498-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W CAMPBELL RD STE 410",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803466",
            "telephone_number": "972-498-8670",
            "fax_number": "972-498-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. GABRIELLE P. PATTERSON M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "GABRIELLE",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "972-498-8670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K5653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.