1. Home
  2. Directory
  3. Texas
  4. Dallas
  5. Obstetrics Gynecology
  6. NPI Profile

NORTHLAKE OB/GYN
NPI 1366555351
Obstetrics & Gynecology in Dallas, TX

Active since August 16, 2006CLIA 45D0665449 · Microscopy
7777 FOREST LN, C-234, DALLAS, TX 75230(972) 566-7711(972) 566-4795 Get Directions Write a Review

NPPES record last updated: September 12, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 12, 2024, Aug 22, 2020 (2 updates tracked since 2020).

About Northlake Ob/gyn NPPES

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

NORTHLAKE OB/GYN (NPI 1366555351) is a healthcare organization registered as an obstetrics & gynecology in Dallas, Texas and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through February 29, 2028 and lists Angie Christon, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1366555351
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameNORTHLAKE OB/GYN
Location Address7777 FOREST LN, C-234Dallas, TX 75230-2505
Mailing Address7777 Forest Ln, C-234Dallas, TX 75230-2505 · (972) 566-7711 · Fax (972) 566-4795
Phone(972) 566-7711
Fax(972) 566-4795
Organization SubpartNo
Authorized OfficialAngie ChristonPractice Administrator · (972) 566-7711
Enumeration DateAugust 16, 2006
Last NPPES UpdateSeptember 12, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 12, 2024
✔ NPI 1366555351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
7777 FOREST LN, Dallas, TX 75230
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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northlake Ob/gyn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Northlake Ob/Gyn, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Jean Mcclintock, M.D., F.A.C.O.G.
Obstetrics/Gynecology
NPI 1619979507
7777 FOREST LN C-234
Dallas, TX 75230
(972) 566-7711
✔ PECOS✔ Accepts MedicareSame address
Michael Ruk, MD
Obstetrics/Gynecology
NPI 1356343255
7777 FOREST LN C-234
Dallas, TX 75230
(972) 566-7711
✔ PECOS✔ Accepts MedicareSame address
Bruce Roberts, M.D., F.A.C.O.G.
Obstetrics/Gynecology
NPI 1104828821
7777 FOREST LN C-234
Dallas, TX 75230
(972) 566-7711
✔ PECOS✔ Accepts Medicare0.1 mi
Kristi Ryder, M.D., F.A.C.O.G.
Obstetrics/Gynecology
NPI 1154323053
7777 FOREST LN C-234
Dallas, TX 75230
(972) 566-7711
✔ PECOS✔ Accepts Medicare0.1 mi
Jennifer Campbell, M.D., F.A.C.O.G.
Obstetrics/Gynecology
NPI 1689675969
6124 W PARKER RD BLDG 3, SUITE 136
Plano, TX 75093
(972) 981-7711
✔ PECOS✔ Accepts Medicare9.9 mi
Garrett Garner, M.D., F.A.C.O.G.
Obstetrics/Gynecology
NPI 1679575393
6124 W PARKER RD BLDG 3, SUITE 136
Plano, TX 75093
(972) 981-7711
✔ PECOS✔ Accepts Medicare9.9 mi
Courtney Trylovich, M.D.
Obstetrics/Gynecology
NPI 1972548519
6124 W PARKER RD # 136
Plano, TX 75093
(972) 981-7711
✔ PECOS✔ Accepts Medicare9.9 mi
Jason Harn, MD
Obstetrics/Gynecology
NPI 1285837476
5757 WARREN PKWY SUITE 200
Frisco, TX 75034
(214) 618-7100
✔ PECOS✔ Accepts Medicare14 mi
Nicole Pendley, MD
Obstetrics/Gynecology
NPI 1023277274
12500 DALLAS PKWY STE 4.200
Frisco, TX 75033
(214) 618-7100
✔ PECOS19 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 for Provider-Performed Microscopy Procedures (PPMP) 45D0665449

Northlake Obstetrics & Gynecology, PA · Dallas, TX
Active · expires Feb 29, 2028
CLIA Number45D0665449
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2026
Certificate Expiration DateFebruary 29, 2028
Laboratory DirectorJean Mcclintock
Laboratory Phone(972) 566-7711
Laboratory LocationNorthlake Obstetrics & Gynecology, PA7777 Forest Lane C 234, Dallas, TX 75230
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Northlake Ob/Gyn's NPI number?

The NPI number for Northlake Ob/Gyn is 1366555351. It was assigned to this organization in the NPPES registry on August 16, 2006.

Where is Northlake Ob/Gyn located?

Northlake Ob/Gyn is located at 7777 Forest Ln C-234, Dallas, TX 75230. The listed phone number is (972) 566-7711.

What is Northlake Ob/Gyn's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Northlake Ob/Gyn enrolled in Medicare?

Yes. Northlake Ob/Gyn is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northlake Ob/Gyn?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians, all in Obstetrics/Gynecology, reassign their Medicare billing to Northlake Ob/Gyn. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Northlake Ob/Gyn hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0665449) is associated with this NPI, valid through February 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northlake Ob/Gyn was last updated on September 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.