Organization Active NPI

Baylor All Saints Medical Center

  • Diagnostic Radiology Physician
  • Fort Worth, TX
National Provider Identifier
1083633143
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
000363 Issued in TX
Legal business name
BAYLOR ALL SAINTS MEDICAL CENTER
Practice address
1400 8TH Avenue
Fort Worth, TX 76104-4110
Phone
(817) 922-1957
Fax
(817) 927-6226
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Charles Williams
Title
Ceo
Phone
(817) 927-6224

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 000363 TX Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 000363 TX
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 000363 TX

Addresses

Primary practice location

1400 8TH Avenue
Fort Worth, TX 76104-4110

Mailing address

PO Box 848108
Dallas, TX 75284-8108
Phone (214) 820-6710

Other identifiers 2

IdentifierTypeStateIssuer
135036506MedicaidTX
CG5772OtherTXRAILROAD

Other names 1

  • Baylor Scott & White All Saints Medical Center - Fort Worth Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1083633143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848108",
            "telephone_number": "214-820-6710",
            "fax_number": "214-820-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVENUE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-922-1957",
            "fax_number": "817-927-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR ALL SAINTS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-927-6224"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "000363",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "000363",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "000363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135036506",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CG5772",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White All Saints Medical Center - Fort Worth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White All Saints Medical Center - Fort Worth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 5, 2024; 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.