Individual provider Active NPI

Keith Shilling Livingstone, MD

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1093747842
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G5305 Issued in TX
Practice address
5531 S Hulen St
Fort Worth, TX 76132-2202
Phone
(817) 346-5960
Fax
(817) 356-5961
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G5305 TX Primary

Addresses

Primary practice location

5531 S Hulen St
Fort Worth, TX 76132-2202

Mailing address

5531 S Hulen St
Fort Worth, TX 76132-2202
Phone (817) 346-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000383 TX Practitioner - Family Practice 9335279876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

809 W Randol Mill Rd
Arlington, TX 76012-2507
Phone (817) 460-0257

900 Airport Fwy
Suite 158
Hurst, TX 76054-3253
Phone (817) 514-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G5305TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas PLLC CurrentSince Oct 1, 2019 Accepting new patients
Medical Clinic of North Texas, PLLC Family Medicine CurrentSince Oct 1, 2019 Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

5531 S Hulen St
Fort Worth, TX 76132
Phone (817) 346-5960

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: keith.livingstone@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1093747842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5531 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322202",
            "telephone_number": "817-346-5960",
            "fax_number": "817-356-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5531 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322202",
            "telephone_number": "817-346-5960",
            "fax_number": "817-356-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTONE",
        "first_name": "KEITH",
        "middle_name": "SHILLING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G5305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.