NPIMap

Individual provider Active NPI

Allison Peddle

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1164784492
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P8170 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-1200
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P8170 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

1500 S Main St
Fort Worth, TX 76104-4917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151014002449 TX Practitioner - Emergency Medicine 7214246271 Reassigns benefits to 2 organizations
I20161214000120 CO Practitioner - Family Practice 7214246271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley-Wide Health Systems, Inc.Group PAC ID 5991609067, 42 clinicians

Practice addresses (Care Compare)

1012 Belmont Ave
La Junta, CO 81050-2101
Phone (719) 383-5900

1710 1St St
Alamosa, CO 81101-2302
Phone (719) 589-3658

702 4TH St
Alamosa, CO 81101-2582
Phone (719) 589-3658

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P8170TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group of Texas PLLC CurrentSince Sep 6, 2015 Accepting new patients
Concord Medical Group PLLC CurrentSince Jun 19, 2016 Accepting new patients
Valley-Wide Health Systems, Inc CurrentSince Nov 2, 2016 Accepting new patients
Valley-Wide Health Systems, Inc. CurrentSince Nov 2, 2016 Accepting new patients
Lutheran Hospital Association of the San Luis Valley Past Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients

Locations

702 4th St
Alamosa, CO 81101
Phone (719) 589-3658

1710 1st St
Alamosa, CO 81101
Phone (719) 589-3633

1131 Main St
Alamosa, CO 81101
Phone (719) 589-2562

128 Market St
Alamosa, CO 81101
Phone (719) 587-1001

106 Blanca Ave
Ste 300
Alamosa, CO 81101
Phone (719) 589-3658

106 Blanca Ave
Alamosa, CO 81101
Phone (719) 589-2511

1012 Belmont Ave
La Junta, CO 81050
Phone (719) 383-5500

245 Vine Ave
Las Animas, CO 81054
Phone (719) 456-1243

903 S 12th St
Rocky Ford, CO 81067
Phone (719) 254-7623

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Interoperability endpoints

  • Direct secure messaging: allison.peddle.p1@direct.vwhs.nextgenshare.com

Organizations & group practices 6

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1164784492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDLE",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P8170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.