NPIMap

Organization Active NPI

Beverly Hills Pain Management

  • General Practice Physician
  • Fort Worth, TX
National Provider Identifier
1104581800
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BEVERLY HILLS PAIN MANAGEMENT
Practice address
3019 South Fwy
Fort Worth, TX 76104-7234
Phone
(323) 868-8099
NPI assigned
Nov 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Authorized official

Name
Dr. Kenneth M Yaker, MDNPI 1427161173
Title
Owner
Phone
(817) 926-5800

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3019 South Fwy
Fort Worth, TX 76104-7234

Mailing address

3019 South Fwy
Fort Worth, TX 76104-7234
Phone (323) 868-8099

National Provider Directory

National Provider Directory

Locations

3019 South Fwy
Ft Worth, TX 76104
Phone (323) 868-8099

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": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1104581800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 SOUTH FWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047234",
            "telephone_number": "323-868-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 SOUTH FWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047234",
            "telephone_number": "323-868-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY HILLS PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "YAKER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-926-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "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 Nov 8, 2021; 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.