Individual provider Active NPI

Nikki Shandell Fox, DO

  • Pain Medicine Physician
  • Ft Worth, TX
National Provider Identifier
1033424932
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
P8131 Issued in TX
Practice address
7235 Boat Club Rd
Ft Worth, TX 76179-4555
Phone
(817) 677-9535
Fax
(817) 677-9536
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 51010179876 MI
Pain Medicine Physician 208VP0000X P8131 TX Primary

Addresses

Primary practice location

7235 Boat Club Rd
Ft Worth, TX 76179-4555

Mailing address

7235 Boat Club Rd
Fort Worth, TX 76179-4555
Phone (817) 677-9535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140407001007 TX Practitioner - Physical Medicine and RehabilitationPractitioner - Pain ManagementPractitioner - Interventional Pain Management 6204068257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management, Pain Management
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Clinic Investments LLCGroup PAC ID 0446659460, 3 clinicians

Practice addresses (Care Compare)

7235 Boat Club Rd
Fort Worth, TX 76179-4555
Phone (817) 677-9535

Hospital & facility affiliations

  • Baylor Scott and White Surgical Hospital Fortworth Hospital, Fort Worth, TX, CCN 450880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
51010179876MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Worth Brain & Spine Institute, LLP CurrentSince Nov 1, 2015 Accepting new patients
Fox Clinic Investments, LLC Physical Medicine & Rehabilitation CurrentSince Feb 11, 2021 Accepting new patients
Texas Pain Professionals, PLLC Interventional Pain Medicine Past Accepting new patients

Locations

7235 Boat Club Rd
Ft Worth, TX 76179
Phone 81748462748002

1900 Mistletoe Blvd
Ste 200
Ft Worth, TX 76104

Interoperability endpoints

  • Direct secure messaging: nfox@isjpc.nexusclinical.phimailbox.com
  • Direct secure messaging: nikki.fox.1@13131.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1033424932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761794555",
            "telephone_number": "817-677-9535",
            "fax_number": "817-677-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 BOAT CLUB RD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761794555",
            "telephone_number": "817-677-9535",
            "fax_number": "817-677-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "NIKKI",
        "middle_name": "SHANDELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "51010179876",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "P8131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.