Organization Active NPI

Neighborhood House Calls PLLC

  • Primary Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1083388243
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
NEIGHBORHOOD HOUSE CALLS PLLC
Practice address
2321 Laurel Forest Dr
Fort Worth, TX 76177-3538
Phone
(254) 231-5793
NPI assigned
Aug 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Authorized official

Name
Tommora JacksonNPI 1497075097
Title
Owner
Phone
(254) 231-5793

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
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

2321 Laurel Forest Dr
Fort Worth, TX 76177-3538

Mailing address

2321 Laurel Forest Dr
Fort Worth, TX 76177-3538
Phone (254) 231-5793

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211001000891 TX Part B Supplier - Clinic/Group Practice 6103224308 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Worth, 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
45D2237007Neighborhood House Calls2321 Laurel Forest Dr, Fort Worth, TX 76177Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory

Locations

12650 N Beach St
Ste 114978
Fort Worth, TX 76244

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26506/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1083388243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 LAUREL FOREST DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761773538",
            "telephone_number": "254-231-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 LAUREL FOREST DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761773538",
            "telephone_number": "254-231-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HOUSE CALLS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TOMMORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-231-5793"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "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 Aug 2, 2021; 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.