NPI age
19 years
Enumerated 2006-06-07
● Active
Type 1 · Individual
MR. Jeffrey J. Fanning, MD
Fanning is 1 of 56 pediatrics providers in Dallas and 1 of 383 in Texas.
Primary specialty
Pediatrics
Plus 2 subspecialties
Licensed in
TX, WI, IN
3 states
Status
Active
No deactivations on record
Last NPPES update
2025-08-11
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 383 active pediatrics providers in Texas.
NPI age
19 years
↑ 3 yr above median (16 yr)
State licenses
3 states
Top 71% — 28% of peers are multi-state
Subspecialties
0
58% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
7777 Forest Ln Ste D569
Dallas, TX 752306903
Mailing address
Po Box 515055
Dallas, TX 752515055
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
835 S Van Buren St
Green Bay, WI 543013526
Location 3
11115 Parkview Plaza Dr
Fort Wayne, IN 468451701
Specialties
-
Pediatrics PrimaryA pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (WI) | 34843900 | |
| 05 (TX) | 204410903 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.