Individual provider Active NPI

John D Gonzalez, RN, DNP,ACNP-BC,NP-C

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1841402831
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP113908 Issued in TX
Practice address
5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone
(214) 590-1396
NPI assigned
May 4, 2007
Last updated
Jun 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 201350013NP OR
Acute Care Nurse Practitioner 363LA2100X AP113908 TX Primary
Adult Health Nurse Practitioner 363LA2200X 201350014NP OR

Addresses

Primary practice location

5201 Harry Hines Blvd
Dallas, TX 75235-7708

Mailing address

820 S Macarthur Blvd
105-119
Coppell, TX 75019-4216
Phone (214) 448-5817

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
I20080501000506 TX Practitioner - Nurse Practitioner 6608955695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

560 N Kimball Ave
Suite 130
Southlake, TX 76092-6879
Phone (469) 312-0355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201350013NPORMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Integrative Health PLLC Acute Care CurrentSince Aug 2, 2022 Accepting new patients

Locations

820 S MacArthur Blvd
Ste 105119
Coppell, TX 75019

560 N Kimball Ave
Ste 130
Southlake, TX 76092
Phone (469) 312-0355

Interoperability endpoints

  • Direct secure messaging: jgonzalez45076@direct.phhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1841402831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S MACARTHUR BLVD",
            "address_2": "105-119",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194216",
            "telephone_number": "214-448-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "RN, DNP,ACNP-BC,NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201350013NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP113908",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201350014NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.