Individual provider Active NPI

Karen Meador, MD

  • Pediatrics Physician
  • Fort Worth, TX
National Provider Identifier
1073573648
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K5625 Issued in TX
Practice address
2106 N Main St
Fort Worth, TX 76164-8511
Phone
(817) 625-4254
Fax
(817) 740-8600
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K5625 TX Primary

Addresses

Primary practice location

2106 N Main St
Fort Worth, TX 76164-8511

Mailing address

2100 N. Main Street
Suite 109
Fort Worth, TX 76164-8572
Phone (817) 625-4254

Other identifiers 1

IdentifierTypeStateIssuer
154004901MedicaidTX

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K5625TXMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1073573648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N. MAIN STREET",
            "address_2": "SUITE 109",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648572",
            "telephone_number": "817-625-4254",
            "fax_number": "817-740-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 N MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648511",
            "telephone_number": "817-625-4254",
            "fax_number": "817-740-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOR",
        "first_name": "KAREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K5625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154004901",
            "state": "TX"
        }
    ],
    "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 24, 2013; 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.