Active NPI
Carly Edgar, PNP
- Pediatric Nurse Practitioner
- Dallas, TX
National Provider Identifier
1871744912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 692499
- Practice address
- 8355 Walnut Hill LN
Suite 200
Dallas, TX 75231-4219 - Phone
- (214) 369-7661
- Fax
- (214) 265-9563
- NPI assigned
- Oct 7, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 692499 | TX | Primary |
Addresses
Primary practice location
8355 Walnut Hill LN
Suite 200
Dallas, TX 75231-4219
Mailing address
8355 Walnut Hill LN
Suite 200
Dallas, TX 75231-4219
Phone (214) 369-7661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 692499 | Other | TX | TEXAS BOARD OF NURSING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 692499 | TX | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- carly.edgar.1@16041.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1871744912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8355 WALNUT HILL LN",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314219",
"telephone_number": "214-369-7661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8355 WALNUT HILL LN",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314219",
"telephone_number": "214-369-7661",
"fax_number": "214-265-9563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGAR",
"first_name": "CARLY",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-07",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "692499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BOARD OF NURSING",
"identifier": "692499",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.