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ADDISON INTERNAL MEDICINE
NPI 1043695695
Nurse Practitioner - Family in Addison, TX

Active since July 24, 2015CLIA 45D2064984 · Waiver
17051 DALLAS PKWY STE 150, ADDISON, TX 75001(972) 733-3090(972) 733-4565 Get Directions Write a Review

NPPES record last updated: July 24, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Addison Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADDISON INTERNAL MEDICINE (NPI 1043695695) is a healthcare organization registered as a family in Addison, Texas and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through August 29, 2027 and lists Tri Nguyen, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1043695695
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameADDISON INTERNAL MEDICINE
Location Address17051 DALLAS PKWY STE 150Addison, TX 75001-7106
Mailing Address17051 Dallas Pkwy Ste 150Addison, TX 75001-7106 · (972) 733-3090 · Fax (972) 733-4565
Phone(972) 733-3090
Fax(972) 733-4565
Organization SubpartNo
Authorized OfficialTri NguyenMedical Director · (972) 733-3090
Enumeration DateJuly 24, 2015
✔ NPI 1043695695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · AP128604
17051 DALLAS PKWY STE 150, Addison, TX 75001
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2064984

Addison Internal Medicine, PA · Dallas, TX
Active · expires Aug 29, 2027
CLIA Number45D2064984
Laboratory TypePhysician Office
Certificate Effective DateAugust 30, 2025
Certificate Expiration DateAugust 29, 2027
Laboratory DirectorTri T. Nguyen
Laboratory Phone(972) 733-3090
Laboratory LocationAddison Internal Medicine, PA16980 Dallas Parkway Ste 110, Dallas, TX 75248
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENUKA SHRINGER NP
Specialist
17051 DALLAS PKWY STE 150
ADDISON, TX 75001
Dallas County (972) 733-3090

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Addison Internal Medicine's NPI number?

The NPI number for Addison Internal Medicine is 1043695695. It was assigned to this organization in the NPPES registry on July 24, 2015.

Where is Addison Internal Medicine located?

Addison Internal Medicine is located at 17051 Dallas Pkwy Ste 150, Addison, TX 75001. The listed phone number is (972) 733-3090.

What is Addison Internal Medicine's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Addison Internal Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2064984) is associated with this NPI, valid through August 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Addison Internal Medicine was last updated on July 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.