Sunnyssix, PLLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP134568 Issued in TX

Legal business name

SUNNYSSIX, PLLC

Practice address

2410 Luna Rd # 204
Carrollton, TX 75006-6538

Phone

(844) 469-7072

NPI assigned

Nov 7, 2017

Organization subpart

No

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

Authorized official

Name

Nidish Jose, NPNPI 1104348903

Title

Ceo

Phone

(817) 823-5464

Specialties & licenses 1

Addresses

Other names 1

• Community First Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nidish Jose, AGNP-C

  • Adult Health Nurse Practitioner
  • Fort Worth, TX
  • NPI 1104348903
  Medicare reassignment NPD Authorized official
• Denise Ann Pack, NP

  • Gerontology Nurse Practitioner
  • Dallas, TX
  • NPI 1124732185
  Medicare reassignment NPD
• Trevor N Parson

  • Family Nurse Practitioner
  • Denton, TX
  • NPI 1417308214
  Medicare reassignment NPD
• Nicole Brown, NP

  • Family Nurse Practitioner
  • Mansfield, TX
  • NPI 1598172041
  NPD (past)
• Carlos Reyes-Pescador, M.D.

  • General Practice Physician
  • Rockwall, TX
  • NPI 1760644975
  NPD (past)

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1972016384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 LUNA RD # 204",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066538",
            "telephone_number": "469-844-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 LUNA RD # 204",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066538",
            "telephone_number": "844-469-7072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2321 Ira E Woods Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760518632",
            "country_code": "US",
            "telephone_number": "469-844-7072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNNYSSIX, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "NIDISH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-823-5464",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP134568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community First Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Gerontology Nurse Practitioner in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.