KATIE COLLEEN PEDICORD (NPI# 1659489920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659489920 |
| Entity Type | Individual |
| Full Name | KATIE COLLEEN PEDICORD |
| Other Name | KATIE COLLEEN ROSE |
| Credential | PA |
| Practice Address |
8230 Walnut Hill Ln Suite 808 Dallas TX 75231-4482 |
| Practice Telephone | 2146968828 |
| Practice Fax Number | 2146961444 |
| Mailing Telephone | 2146968828 |
| Mailing Fax Number | 2146961444 |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2013-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA04430 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA04430 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8230 WALNUT HILL LN SUITE 808 |
| City | DALLAS |
| State | TX |
| Zip Code | 75231-4482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356347454 | Swdic Imaging Center Partnership, LLP | Clinic/Center | 8230 Walnut Hill Ln, Suite 100, Dallas, TX 75231-4482 | 2005-06-23 |
| 1437609484 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 8230 Walnut Hill Ln, Professional Bldg IIi, Suite 320, Dallas, TX 75231-4482 | 2016-10-13 |
| 1760838692 | Dns-jt LLC | Physician Assistant | 8230 Walnut Hill Ln, Ste 220, Dallas, TX 75231-4482 | 2016-05-10 |
| 1528427416 | Omni Hand Surgery, Pllc | Plastic Surgery | 8230 Walnut Hill Ln, Professional Building IIi Suite 212, Dallas, TX 75231-4482 | 2016-02-19 |
| 1588021638 | Dns-rw LLC | Registered Nurse | 8230 Walnut Hill Ln, Ste 220, Dallas, TX 75231-4482 | 2016-01-20 |
| 1528444635 | Dns-rj LLC | Physician Assistant | 8230 Walnut Hill Ln, Suite 220, Dallas, TX 75231-4482 | 2015-07-31 |
| 1396127304 | Vertical Dynamics, LLC | Registered Nurse | 8230 Walnut Hill Ln, Suite 220, Dallas, TX 75231-4482 | 2015-06-25 |
| 1902288996 | Dns-jd, LLC | Physician Assistant | 8230 Walnut Hill Ln, Suite 220, Dallas, TX 75231-4482 | 2015-06-25 |
| 1265814263 | Dns-md, LLC | Physician Assistant | 8230 Walnut Hill Ln, Suite 220, Dallas, TX 75231-4482 | 2015-06-25 |
| 1215319215 | Dns-jk, LLC | Nurse Practitioner | 8230 Walnut Hill Ln, Suite 220, Dallas, TX 75231-4482 | 2015-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987022 | Specialists In Geriatric and Palliative Care Medicine Pllc | Clinic/Center | 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 | 2020-09-21 |
| 1013546118 | The Legacy Midtown Park, Inc | Skilled Nursing Facility | 8280 Manderville Lane, Dallas, TX 75231 | 2020-04-02 |
| 1003383373 | Northeast Dallas Dentistry, PC | Dentist | 6401 East Northwest Highway, Suite 100, Dallas, TX 75231 | 2018-10-25 |
| 1518442565 | Daniel Max & Marc Andrea LLC | Optometrist | 6471 E Northwest Hwy, Dallas, TX 75231 | 2018-09-26 |
| 1760964100 | Amber Nicole Caruthers | Nurse Practitioner | 8060 Park Lane, Dallas, TX 75231 | 2018-09-01 |
| 1376024893 | Brittany Leigh Stedman | Physical Therapist | 8130 Meadow Rd, Dallas, TX 75231 | 2018-08-23 |
| 1700367224 | Tia Cornelius | Occupational Therapy Assistant | 8130 Meadow Rd., Dallas, TX 75231 | 2018-08-23 |
| 1538653753 | Manju R. Goyal M.d. Psychiatry Pllc | Psychiatry & Neurology | 5477 Glen Lakes Dr Ste 210, Dallas, TX 75231 | 2018-06-20 |
| 1497246813 | Stacy Jo Thomas | Counselor | 10260 N Central Expy Ste 280, Dallas, TX 75231 | 2018-05-21 |
| 1235626615 | Texas Health Presbyterian Hospital Dallas | Durable Medical Equipment & Medical Supplies | 8160 Walnut Hill Lane, First Floor, Dallas, TX 75231 | 2018-04-20 |
| Find all providers in zip 75231 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641051 | Kelsey Young | Physician Assistant | 12201 Merit Dr Ste 400, Dallas, TX 75251-3117 | 2019-07-17 |
| 1558863555 | Kyra Nicole Logan | Physician Assistant | 221 W Colorado Blvd Pav II Ste. 425, Dallas, TX 75208-7520 | 2018-03-06 |
| 1386169175 | Lauren Moore | Physician Assistant | 5201 Harry Hines Blvd Fl Htower1, Dallas, TX 75235-7708 | 2017-08-14 |
| 1811427594 | Jena Benik | Physician Assistant | 7777 Forest Ln Ste B122, Dallas, TX 75230-6806 | 2017-06-15 |
| 1881123909 | One Healthcare LLC | Physician Assistant | 1722 Routh St Ste 900, Dallas, TX 75201-2588 | 2017-06-12 |
| 1972037307 | Morrison Medical | Physician Assistant | 17746 Preston Rd Ste 100, Dallas, TX 75252-5736 | 2017-04-12 |
| 1205297652 | Keri Miller | Physician Assistant | 9780 Lbj Fwy Ste 124, Dallas, TX 75243-6847 | 2016-03-14 |
| 1275907776 | Aleshia Mutai | Physician Assistant | 5800 E Lovers Ln, Dallas, TX 75206-2901 | 2015-11-20 |
| 1588049613 | Yvonne Conard | Physician Assistant | 2650 Cedar Springs Rd, #5535, Dallas, TX 75201-1495 | 2015-07-30 |
| 1699174599 | John Michael Cline | Physician Assistant | 5201 Harry Hines Boulevard, Psychiatric Emergency Room, Dallas, TX 75235 | 2014-08-15 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.