Organization Active NPI

Emcc Chisholm Trail Physicians PLLC

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1104395359
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMCC CHISHOLM TRAIL PHYSICIANS PLLC
Practice address
7445 Oakmont Blvd
Fort Worth, TX 76132-3905
Phone
(817) 423-8444
Fax
(817) 423-8446
NPI assigned
Nov 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Michelle Newsom
Title
President
Phone
(469) 830-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

7445 Oakmont Blvd
Fort Worth, TX 76132-3905

Mailing address

2300 Matlock Rd Ste 35
Mansfield, TX 76063-5018
Phone (469) 830-8200

National Provider Directory

National Provider Directory

Locations

960 Ridgeview Dr
Ste 140123
Allen, TX 75013

7445 Oakmont Blvd
Ft Worth, TX 76132
Phone (817) 423-8444

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1104395359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MATLOCK RD STE 35",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635018",
            "telephone_number": "469-830-8200",
            "fax_number": "469-830-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7445 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323905",
            "telephone_number": "817-423-8444",
            "fax_number": "817-423-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMCC CHISHOLM TRAIL PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "NEWSOM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-830-8200"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "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 May 18, 2023; 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.