Active NPI
JPS Physician Group Inc.
- Hospitalist Physician
- Fort Worth, TX
National Provider Identifier
1073761805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- Legal business name
- JPS PHYSICIAN GROUP INC.
- Practice address
- 1617 Hemphill St
Fort Worth, TX 76104-4709 - Phone
- (817) 852-8440
- Fax
- (817) 927-3603
- NPI assigned
- Sep 4, 2008
- Last updated
- Sep 4, 2008
- Organization subpart
- Yes
- Parent organization
- JPS PHYSICIAN GROUP INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Corbin Wilson
- Title
- Executive Director
- Phone
- (817) 921-3431
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | NU | Primary |
Addresses
Primary practice location
1617 Hemphill St
Fort Worth, TX 76104-4709
Mailing address
19801 Anita Ave
Castro Valley, CA 94546-4103
Phone (650) 743-6473
National Provider Directory
National Provider Directory- Part of
- John Peter Smith Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1220486400000",
"number": "1073761805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19801 ANITA AVE",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945464103",
"telephone_number": "650-743-6473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 HEMPHILL ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044709",
"telephone_number": "817-852-8440",
"fax_number": "817-927-3603"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JPS PHYSICIAN GROUP INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JPS PHYSICIAN GROUP INC.",
"enumeration_date": "2008-09-04",
"last_updated": "2008-09-04",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "CORBIN",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "817-921-3431",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NU",
"license": null,
"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 Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.