Individual provider Active NPI

Carlos Enrique Espada, CPNP

  • Acute Care Nurse Practitioner
  • Prosper, TX
National Provider Identifier
1922770809
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1073110 Issued in TX
Practice address
4100 W University Dr
Prosper, TX 75078-3123
Phone
(945) 204-4100
Fax
(682) 885-1903
NPI assigned
Sep 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 824574 TX
Critical Care Pediatric Nurse Practitioner 363LP0222X 1073110 TX
Acute Care Nurse Practitioner 363LA2100X 1073110 TX Primary

Addresses

Primary practice location

4100 W University Dr
Prosper, TX 75078-3123

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address espada162628@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220426002035 TX Practitioner - Nurse Practitioner 1456748268 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
824574TXMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Current Accepting new patients
Cook Children'S Physician Network CurrentSince Feb 26, 2024 Accepting new patients
Cook Children'S Physician Network CurrentSince Feb 26, 2024 Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

7777 Forest Ln
Ste C300
Dallas, TX 75230
Phone (972) 566-6000

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163

6316 Precinct Line Rd
Hurst, TX 76054
Phone (817) 605-2500

4100 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: cespada162628@cookchildrens.direct-ci.com
  • Direct secure messaging: espada162628@cookchildrens.direct-ci.com

Organizations & group practices 4

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": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1922770809",
    "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": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783123",
            "telephone_number": "945-204-4100",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPADA",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-29",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "824574",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "TX",
            "license": "1073110",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1073110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "espada162628@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4100 W University Dr",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750783123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.