Michael James Parker

Primary specialty

PsychologistTaxonomy code 103T00000X

License

31136 Issued in TX

Practice address

1300 Circle Dr
Fort Worth, TX 76119-8113

Phone

(817) 569-4801

Fax

(817) 569-4108

NPI assigned

Dec 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1194156414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CIRCLE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761198113",
            "telephone_number": "817-569-4801",
            "fax_number": "817-569-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CIRCLE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761198113",
            "telephone_number": "817-569-4801",
            "fax_number": "817-569-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "31136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330146701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHC",
            "identifier": "330146702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88933A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Wayne Parker, D.C.
• Leighton Brown Parker, M.D.
• Lindsay Liebreich Parker
• Lisa D Parker, R.D., L.D.
• Meredith L Parker, O.T.
• Richard George Parker, M.D.
• Ryan Elizabeth Parker, MD
• Sandra K Parker, NP
• Sara Parker, D.C.
• Parkhill Imaging LLC

• Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.