Individual provider Active NPI

Jacquelyn Conaway Shekarchi, CPNP

  • Pediatric Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1861747024
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
658583 Issued in TX
Practice address
1920 N Main St
Mansfield, TX 76063-3936
Phone
(817) 702-5120
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 658583 TX Primary
Pediatric Nurse Practitioner 363LP0200X AP122031 TX

Addresses

Primary practice location

1920 N Main St
Mansfield, TX 76063-3936

Mailing address

921 Garden Park Dr Apt 415
Allen, TX 75013-3761
Phone (817) 702-5120

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
I20131016000632 TX Practitioner - Nurse Practitioner 6608000146 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
658583TXMDPediatric Nurse Practitioner
AP122031TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Jan 15, 2024 Accepting new patients

Locations

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

1920 N Main St
Mansfield, TX 76063
Phone (817) 702-5120

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1861747024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 GARDEN PARK DR APT 415",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133761",
            "telephone_number": "817-702-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 N MAIN ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633936",
            "telephone_number": "817-702-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEKARCHI",
        "first_name": "JACQUELYN",
        "middle_name": "CONAWAY",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "658583",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP122031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.