Organization Active NPI

James R Haden, MD, PA

  • Allergy & Immunology Physician
  • Fort Worth, TX
National Provider Identifier
1124063706
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
L0234 Issued in TX
Legal business name
JAMES R HADEN, MD, PA
Practice address
1000 College Ave
Fort Worth, TX 76104-3033
Phone
(817) 336-8855
Fax
(817) 336-4228
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James R Haden, MDNPI 1588691125
Title
President
Phone
(817) 336-8855

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
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X L0234 TX Primary

Addresses

Primary practice location

1000 College Ave
Fort Worth, TX 76104-3033

Mailing address

1000 College Ave
Fort Worth, TX 76104-3033
Phone (817) 336-8855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190502000705 TX Part B Supplier - Clinic/Group Practice 3577805027 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

1000 College Ave
Fort Worth, TX 76104
Phone (817) 336-8855

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124063706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043033",
            "telephone_number": "817-336-8855",
            "fax_number": "817-336-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043033",
            "telephone_number": "817-336-8855",
            "fax_number": "817-336-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R HADEN, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HADEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-336-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "L0234",
            "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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.