Casey Roskydoll
Individual provider Active NPI Licensed Vocational Nurse · Northlake, TX
NPI 1992347462 · NPPES record last updated Oct 16, 2019
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 19, 2024.
Key facts
- NPI
- 1992347462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 314253 (TX)
- Practice address
- 13861 Raceway Dr Apt 732
Northlake, TX 76262-6557 - Phone
- (682) 429-6272
- NPI assigned
- Oct 16, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 314253 | TX | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 314253 | TX | Yes |
Addresses
Primary practice location
13861 Raceway Dr Apt 732
Northlake, TX 76262-6557
Mailing address
13861 Raceway Dr Apt 732
Northlake, TX 76262-6557
Phone (682) 429-6272
Other providers in Northlake, TX
- Cindi Ann Peters
- Pharmacy Plus Inc
- Play on Words Pediatric Speech Therapy
- PM Partnership PLLC
- PMP - Northlake PLLC
- Megan Rutel
- Sacred Smiles PLLC
- Lisethe Salcido
- Harriette Sama
- Shani Krupa PLLC
All providers in Northlake, TX · Licensed Vocational Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.