Active NPI
Kory Sue Cummings, O.D.
- Optometrist
- Fort Worth, TX
National Provider Identifier
1134167018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4963T
- Practice address
- 1101 W Rosedale St
Fort Worth, TX 76104-4425 - Phone
- (817) 294-4834
- Fax
- (817) 423-7382
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4963T | TX | Primary |
Addresses
Primary practice location
1101 W Rosedale St
Fort Worth, TX 76104-4425
Mailing address
1101 W Rosedale St
Fort Worth, TX 76104-4425
Phone (817) 294-4834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2016 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4963 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289952000000",
"number": "1134167018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 W ROSEDALE ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044425",
"telephone_number": "817-294-4834",
"fax_number": "817-423-7382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 W ROSEDALE ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044425",
"telephone_number": "817-294-4834",
"fax_number": "817-423-7382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUMMINGS",
"first_name": "KORY",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-03",
"last_updated": "2010-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "4963T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Cultivation Clinical Services PLLC
- Cumberland Rest Inc (Trinity Terrace)
- Patricia Lynn Cumer, CRNA
- Baylee Yvonne Cuming, RN
- Anne M Cummings-Bridge, LCSW LMFT LCDC
- Patricia Anquinette Cummings, LVN
- Princetta Cyntrelle Cummings
- Sherryl Cummings
- Sharon Marie Cummins, FNP
- Cumulus Injury Resolution, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.