Suzanne Sophia Wombough, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1010579 Issued in TX

Practice address

6844 Harris Parkway
Fort Worth, TX 76132

Phone

(817) 263-0007

Fax

(817) 263-1118

NPI assigned

Sep 20, 2020

Last updated

Jul 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: suzane.wombouch.p1@direct.emm.nextgenshare.com

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

• Anjanette Tan MD PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Worth, TX
  • NPI 1649989237
  Medicare reassignment NPD
• Diabetes and Thyroid Center of Fort Worth, PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Worth, TX
  • NPI 1326373143
  Medicare reassignment NPD

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

{
    "created_epoch": "1600560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1124634621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6844 HARRIS PARKWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-263-0007",
            "fax_number": "817-263-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6844 HARRIS PARKWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-263-0007",
            "fax_number": "817-263-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2110 Tarleton Ct",
            "address_purpose": "LOCATION",
            "city": "Colleyville",
            "state": "TX",
            "postal_code": "760345663",
            "country_code": "US",
            "telephone_number": "214-929-4696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMBOUGH",
        "first_name": "SUZANNE",
        "middle_name": "SOPHIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-20",
        "last_updated": "2023-07-03",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1010579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Womack
• Jessica Diane Womack, MPA, PA-C
• Elizabeth Wombaker
• Christopher Chad Womble, DPT
• Eric Matthew Womboldt
• Craig Mahlon Womeldorph, DO
• Women's Integrated Healthcare, P.a.
• Yared Astawesegn Wondemagegn, MD
• Wonderful Wigs on the Go, LLC
• Christina A. Wong, PTA

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.