Individual provider Active NPI

Vanessa S Charette, MD

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1851405534
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L3940 Issued in TX
Practice address
1263 W Rosedale St
Fort Worth, TX 76104-2830
Phone
(817) 336-4896
Fax
(817) 332-2805
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L3940 TX Primary

Addresses

Primary practice location

1263 W Rosedale St
Fort Worth, TX 76104-2830

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vcharette12924@CookChildrens.direct-ci.com
Direct Messaging Address vcharette12924@CookChildrens.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000553 TX Practitioner - Pediatric Medicine 4284705625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L3940TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Sep 30, 2015 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Sep 30, 2015 Accepting new patients
Cook Children'S Medical Center PastSince May 16, 2021 Accepting new patients

Locations

1129 6th Ave
Fort Worth, TX 76104
Phone (682) 885-6248

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

Interoperability endpoints

  • Direct secure messaging: vcharette12924@cookchildrens.direct-ci.com

Organizations & group practices 3

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1851405534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 W ROSEDALE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042830",
            "telephone_number": "817-336-4896",
            "fax_number": "817-332-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARETTE",
        "first_name": "VANESSA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L3940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vcharette12924@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1129 6th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vcharette12924@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1263 W Rosedale St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.