Individual provider Active NPI

David Glenn Troutman, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1174747414
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J4572 Issued in TX
Practice address
11801 South Freeway
Fort Worth, TX 76115-0337
Phone
(817) 293-9110
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J4572 TX Primary

Addresses

Primary practice location

11801 South Freeway
Fort Worth, TX 76115-0337

Mailing address

PO Box 6426
Fort Worth, TX 76115-0426
Phone (817) 293-1000

Other identifiers 1

IdentifierTypeStateIssuer
0363368-01MedicaidTX

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130218000466 TX Practitioner - Internal Medicine 2466606652 Reassigns benefits to 1 organization
Practice locations: Burleson, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11801 S Fwy
Burleson, TX 76028-7021
Phone (817) 293-9110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J4572TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart to Heart Hospice of the Brazos, LLC CurrentSince Sep 18, 2023 Accepting new patients

Locations

504 N Ridgeway Dr
Ste A
Cleburne, TX 76033
Phone (682) 231-7818

7240 Chase Oaks Blvd
Plano, TX 75025
Phone (972) 517-6300

Organizations & group practices 1

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 5

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1174747414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6426",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761150426",
            "telephone_number": "817-293-1000",
            "fax_number": "817-293-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FREEWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761150337",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTMAN",
        "first_name": "DAVID",
        "middle_name": "GLENN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J4572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0363368-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.