Active NPI
Kimberly J Parham, MD
- Dermatology Physician
- Fort Worth, TX
National Provider Identifier
1073538948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- K2257
- Practice address
- 6600 Bryant Irvin Rd
Fort Worth, TX 76132-4217 - Phone
- (817) 820-0011
- Fax
- (817) 820-0073
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | K2257 | TX | Primary |
Addresses
Primary practice location
6600 Bryant Irvin Rd
Fort Worth, TX 76132-4217
Mailing address
2902 Rivercove CT
Fort Worth, TX 76116-0806
Phone (903) 277-1587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18987 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433635200000",
"number": "1073538948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2902 RIVERCOVE CT",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761160806",
"telephone_number": "903-277-1587",
"fax_number": "903-223-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 BRYANT IRVIN RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761324217",
"telephone_number": "817-820-0011",
"fax_number": "817-820-0073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARHAM",
"first_name": "KIMBERLY",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2015-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "K2257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.