NPIMap

Organization Active NPI

FMC Medical Foundation, Inc

  • Pediatrics Physician
  • Amarillo, TX
National Provider Identifier
1003825852
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FMC MEDICAL FOUNDATION, INC
Practice address
1500 S Coulter St Ste 1
Amarillo, TX 79106-1787
Phone
(806) 354-0404
Fax
(806) 354-2810
NPI assigned
Aug 7, 2006
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stefanie Feemster
Title
Credentialing Specialist
Phone
(806) 358-9400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1500 S Coulter St Ste 1
Amarillo, TX 79106-1787

Mailing address

1500 S Coulter St Ste 1
Amarillo, TX 79106-1787
Phone (806) 354-0404

Other names 1

  • Panhandle Pediatric Group P A Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
FMC Medical Foundation Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1500 S Coulter St
Amarillo, TX 79106
Phone (806) 354-0404

1500 S Coulter St
Ste 1
Amarillo, TX 79106
Phone (806) 354-0404

1901 Medi Park Dr
#1501
Amarillo, TX 79106
Phone (806) 354-0404

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1003825852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S COULTER ST STE 1",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061787",
            "telephone_number": "806-354-0404",
            "fax_number": "806-354-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S COULTER ST STE 1",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061787",
            "telephone_number": "806-354-0404",
            "fax_number": "806-354-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMC MEDICAL FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "FEEMSTER",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "806-358-9400"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panhandle Pediatric Group P A",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.