Organization Active NPI

Arlington Progressive Health Center Inc.

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1013644608
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ARLINGTON PROGRESSIVE HEALTH CENTER INC.
Practice address
306 E Randol Mill Rd Ste 136
Arlington, TX 76011-5841
Phone
(682) 597-5097
NPI assigned
Aug 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Mr. Adebayo Olatunji, NPNPI 1376054718
Title
Administrator
Phone
(682) 597-5097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

306 E Randol Mill Rd Ste 136
Arlington, TX 76011-5841

Mailing address

2600 Mall Cir
Fort Worth, TX 76116-1546
Phone (817) 870-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220924000135 TX Part B Supplier - Clinic/Group Practice 9234514415 Receives reassigned benefits from 2 practitioners
Practice locations: Arlington, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2275654Arlington Progressive Health Center306 E Randol Mill Rd Suite 136, Arlington, TX 76011Certificate of waiverJan 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1013644608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MALL CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761161546",
            "telephone_number": "817-870-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E RANDOL MILL RD STE 136",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760115841",
            "telephone_number": "682-597-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARLINGTON PROGRESSIVE HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "OLATUNJI",
        "authorized_official_first_name": "ADEBAYO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "682-597-5097",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.