Individual provider Active NPI

Alyza Sarah Sunny, FNP-C

  • Family Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1831869031
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1036721 Issued in TX
Practice address
855 Davis Blvd Ste 500
Southlake, TX 76092-8218
Phone
(940) 648-8191
NPI assigned
Sep 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1036721 TX Primary

Addresses

Primary practice location

855 Davis Blvd Ste 500
Southlake, TX 76092-8218

Mailing address

7514 Harbor Dr
Rowlett, TX 75088-5328

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
I20211014002714 TX Practitioner - Nurse Practitioner 5294133625 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1036721TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Texas PA CurrentSince Aug 22, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Organizations & group practices 2

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": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1831869031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 HARBOR DR",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750885328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 DAVIS BLVD STE 500",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928218",
            "telephone_number": "940-648-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNNY",
        "first_name": "ALYZA",
        "middle_name": "SARAH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-18",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1036721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.