NPIMap

Organization Active NPI

Rainbow Children'S Clinic, P.a.

  • Pediatrics Physician
  • Arlington, TX
National Provider Identifier
1174828289
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
RAINBOW CHILDREN'S CLINIC, P.A.
Practice address
1900 Ballpark Way
Ste 106
Arlington, TX 76006-6610
Phone
(817) 704-7339
Fax
(682) 558-8008
NPI assigned
Jan 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Dr. Ruth Bernardez- Tan, M.D.NPI 1598709149
Title
Pediatrics
Phone
(682) 276-6700

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
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X TX Primary

Addresses

Primary practice location

1900 Ballpark Way
Ste 106
Arlington, TX 76006-6610

Mailing address

1900 Ballpark Way
Suite 106
Arlington, TX 76006-6610
Phone (817) 704-7339

Other identifiers 6

IdentifierTypeStateIssuer
045321904MedicaidTX
G19885OtherTXUPIN
218565401MedicaidTX
218565402MedicaidTX
218565403MedicaidTX
045321903MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Rainbow Children'S Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1915 E Mayfield Rd
Arlington, TX 76014

1900 Ballpark Way
Arlington, TX 76006

1900 Ballpark Way
Ste 106
Arlington, TX 76006
Phone (817) 704-7339

Practitioners & affiliated clinicians

Practitioners 7

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": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1174828289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 BALLPARK WAY",
            "address_2": "SUITE 106",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760066610",
            "telephone_number": "817-704-7339",
            "fax_number": "682-558-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 BALLPARK WAY",
            "address_2": "STE 106",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760066610",
            "telephone_number": "817-704-7339",
            "fax_number": "682-558-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW CHILDREN'S CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "BERNARDEZ- TAN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "PEDIATRICS",
        "authorized_official_telephone_number": "682-276-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045321904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G19885",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218565401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218565402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218565403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045321903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.