Sally B Plourde, PNP

Primary specialty

Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X

License

AP121376 Issued in TX

Practice address

6425 S Ih 35 Ste 100
Austin, TX 78744-4230

Phone

(512) 744-6000

Fax

(512) 225-6520

NPI assigned

Oct 19, 2012

Last updated

Apr 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sallypnp@mvpkidscare.opdirect.net

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.

• Maryvale Pediatric Clinic

  dba MVP Kids Care

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1366605529
  NPD (past)

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1831442490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 N LAMAR BLVD STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534179",
            "telephone_number": "512-583-9679",
            "fax_number": "512-233-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 S IH 35 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787444230",
            "telephone_number": "512-744-6000",
            "fax_number": "512-225-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOURDE",
        "first_name": "SALLY",
        "middle_name": "B",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "541988",
            "primary": false
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "TX",
            "license": "AP121376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3280315-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristina Plessinger, LCSW
• Abigail Ploch, RD
• Lisa Francis Plotkin, PA-C
• Nathan Plotkin
• Sarah Jordan Plotycia, OTR
• Juanita Tatyana Plowell
• Emanuela Marianna Plummer, PA-C
• Brandy N Plunk, L.AC
• Alexa Plunkett
• Curtesia Plunkett, PHD

• Pediatric Clinical Nurse Specialist in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.