| Evernorth Care Providers - Delaware Pa | |
|
320 Decker Dr Irving TX 75062-3999 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Delaware Pa |
|---|---|
| Speciality | General Practice |
| Location | 320 Decker Dr, Irving, Texas |
| Authorized Official Name and Position | Grace Blue (CREDENTIALING SR. MANAGER) |
| Authorized Official Contact | 7732924800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evernorth Care Providers - Delaware Pa 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Delaware Pa 320 Decker Dr Irving TX 75062-3999 Ph: (773) 292-4800 |
| NPI Number | 1033981097 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 11/17/2023 |
| Medicare PECOS PAC ID | 6002217973 |
|---|---|
| Medicare Enrollment ID | O20240206004349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033981097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ingrid C Hinojosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851399240 PECOS PAC ID: 8325021934 Enrollment ID: I20040612000188 |
| Provider Name | Jolene Sonnier Hanzik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720139314 PECOS PAC ID: 4183639149 Enrollment ID: I20060213000134 |
| Provider Name | Sharon Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316014822 PECOS PAC ID: 4385714146 Enrollment ID: I20080605000134 |
| Provider Name | Melanie M Schneidmiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083852347 PECOS PAC ID: 9335287762 Enrollment ID: I20091105000181 |
| Provider Name | Nancy G Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750517512 PECOS PAC ID: 9638294895 Enrollment ID: I20100913000507 |
| Provider Name | Lindsay A Valle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134409261 PECOS PAC ID: 3577737865 Enrollment ID: I20111123000170 |
| Provider Name | Aimee Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306803507 PECOS PAC ID: 8729060421 Enrollment ID: I20120419000551 |
| Provider Name | Charlotte Isah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366883035 PECOS PAC ID: 2466686860 Enrollment ID: I20131017000753 |
| Provider Name | Miranda N Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588058259 PECOS PAC ID: 5698093722 Enrollment ID: I20150421001276 |
| Provider Name | Thelma I Arzu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750788782 PECOS PAC ID: 9133440365 Enrollment ID: I20150601000171 |
| Provider Name | Karen Sue Farnum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487039087 PECOS PAC ID: 4385950252 Enrollment ID: I20150909000491 |
| Provider Name | Chrystal Pena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699155689 PECOS PAC ID: 2860709748 Enrollment ID: I20150910001220 |
| Provider Name | Tammy Danise Smith |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1841675253 PECOS PAC ID: 8527369040 Enrollment ID: I20151228002268 |
| Provider Name | Rafael Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902265788 PECOS PAC ID: 0345530747 Enrollment ID: I20160525003050 |
| Provider Name | Julia R Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174908974 PECOS PAC ID: 2567755101 Enrollment ID: I20160720000941 |
| Provider Name | Susan Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821468257 PECOS PAC ID: 3375853054 Enrollment ID: I20160921000937 |
| Provider Name | Peter Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649637489 PECOS PAC ID: 7618252958 Enrollment ID: I20170328002245 |
| Provider Name | Abiola Atobatele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164971453 PECOS PAC ID: 0749550606 Enrollment ID: I20170725004036 |
| Provider Name | Norma Linda Cantu-castaneda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043743750 PECOS PAC ID: 5991065963 Enrollment ID: I20180213000316 |
| Provider Name | Lauren B Cordell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518353812 PECOS PAC ID: 9931420643 Enrollment ID: I20180521000915 |
| Provider Name | Candace Breaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366676132 PECOS PAC ID: 2264784586 Enrollment ID: I20181015000300 |
| Provider Name | Rene R Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538630355 PECOS PAC ID: 8921343435 Enrollment ID: I20190102001429 |
| Provider Name | Rhonda K Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376017301 PECOS PAC ID: 6901147438 Enrollment ID: I20190411000282 |
| Provider Name | Stephane Cyriaque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780192633 PECOS PAC ID: 7618305756 Enrollment ID: I20200324000388 |
| Provider Name | Nancy E Tabot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902443062 PECOS PAC ID: 7810311065 Enrollment ID: I20200721001418 |
| Provider Name | Breana Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912504176 PECOS PAC ID: 3173923232 Enrollment ID: I20210610001313 |
| Provider Name | Alejandra Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891395133 PECOS PAC ID: 9638579147 Enrollment ID: I20210621000302 |
| Provider Name | Olateju Ishola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063086122 PECOS PAC ID: 7416358981 Enrollment ID: I20210622003044 |
| Provider Name | Jeannette K George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043987753 PECOS PAC ID: 2668878125 Enrollment ID: I20210908002721 |
| Provider Name | Ashley Marie De La Fuente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053021105 PECOS PAC ID: 3476928680 Enrollment ID: I20230331000283 |
| Provider Name | Bairat Shasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770021230 PECOS PAC ID: 6002149796 Enrollment ID: I20230404001950 |
| Provider Name | Janis Correa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659906683 PECOS PAC ID: 3971960436 Enrollment ID: I20230530000579 |
| Provider Name | Dora Tirado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740846211 PECOS PAC ID: 3870929599 Enrollment ID: I20230605003342 |
| Provider Name | Nancy W Kiarie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356038079 PECOS PAC ID: 1153780515 Enrollment ID: I20230702000037 |
| Provider Name | Njukam Ngufac Loveline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508114489 PECOS PAC ID: 7315300415 Enrollment ID: I20230822003185 |
| Provider Name | Jessica Suzanne Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821675158 PECOS PAC ID: 5395145593 Enrollment ID: I20230918000816 |
| Provider Name | Santa Badeg Sisay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033857073 PECOS PAC ID: 2668826223 Enrollment ID: I20230929003060 |
| Provider Name | Janja Matic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336648757 PECOS PAC ID: 4082061262 Enrollment ID: I20231109000850 |
| Provider Name | Charlie Kroelinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538697784 PECOS PAC ID: 6204105810 Enrollment ID: I20240405001065 |
| Provider Name | Jessica Lynne Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891493250 PECOS PAC ID: 8921549056 Enrollment ID: I20240917001947 |
| Provider Name | Savannah Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164872529 PECOS PAC ID: 8123312121 Enrollment ID: I20250102000255 |
Sunil Mathews, Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7701 Las Colinas Rdg Ste 260, Irving, TX 75063 Phone: 972-869-3448 Fax: 972-459-7729 | |
Le Opti Tech Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 708 N Macarthur Blvd, Irving, TX 75061 Phone: 972-254-0033 Fax: 972-254-0055 | |
Reliant Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1302 Lane St, Suite # 300, Irving, TX 75061 Phone: 817-808-3443 Fax: 817-887-5522 | |
E. S. Romanelli, Md., Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1141 Kinwest Pkwy, Suite 100, Irving, TX 75063 Phone: 214-239-2222 Fax: 214-239-2223 | |
Do Not Use Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1706 W Irving Blvd, Irving, TX 75061 Phone: 972-254-1474 Fax: 972-259-3037 | |
Myrna Bucaling Carag West Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 219 S O Connor Rd, Irving, TX 75060 Phone: 972-254-5000 Fax: 972-254-2540 |