Organization Active NPI

Medhealth Center Inc

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1174957054
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDHEALTH CENTER INC
Practice address
112 NW 24TH St Ste 206
Fort Worth, TX 76164-8577
Phone
(817) 625-4100
NPI assigned
Aug 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Authorized official

Name
Anna Penkova
Title
President
Phone
(817) 625-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

112 NW 24TH St Ste 206
Fort Worth, TX 76164-8577

Mailing address

112 NW 24TH St Ste 206
Fort Worth, TX 76164-8577
Phone (817) 625-4100

National Provider Directory

National Provider Directory

Locations

112 NW 24th St
Ste 206
Fort Worth, TX 76164
Phone (817) 625-4100

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1174957054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NW 24TH ST STE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648577",
            "telephone_number": "817-625-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NW 24TH ST STE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648577",
            "telephone_number": "817-625-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDHEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "PENKOVA",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-625-4100"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.