North Central Texas Orthopaedics and Sports Medicine PA

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

J0118 Issued in TX

Legal business name

NORTH CENTRAL TEXAS ORTHOPAEDICS AND SPORTS MEDICINE PA

Practice address

2800 E TX Highway 114 Ste 130
Trophy Club, TX 76262-5305

Phone

(469) 916-4435

Fax

(855) 959-1785

NPI assigned

Apr 24, 2006

Organization subpart

No

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

Authorized official

Name

Randall McKenna, DONPI 1063477552

Title

DO

Phone

(940) 627-3491

Specialties & licenses 7

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall Wade McKenna, DO

  • Orthopaedic Surgery Physician
  • Decatur, TX
  • NPI 1063477552
  Medicare reassignment NPD Authorized official
• Christian Boyce Helm, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Decatur, TX
  • NPI 1750585600
  Medicare reassignment NPD
• Brad Alan Matlock

  • Orthopedic Physical Therapist
  • Decatur, TX
  • NPI 1790265528
  Medicare reassignment NPD
• Kirby Tinsley, PA-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1023425147
  Medicare reassignment

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1194781773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E TX HWY 114",
            "address_2": "STE 130",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "469-916-4435",
            "fax_number": "855-959-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E TX HIGHWAY 114 STE 130",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625305",
            "telephone_number": "469-916-4435",
            "fax_number": "855-959-1785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1713 S FM 51",
            "address_2": "Ste 103",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "TX",
            "postal_code": "76234",
            "country_code": "US",
            "telephone_number": "940-627-6976",
            "fax_number": "940-627-3491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH CENTRAL TEXAS ORTHOPAEDICS AND SPORTS MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "940-627-3491",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "J0118",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "K7089",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "M6477",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1305",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "J0118",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1141880001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080630901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89Z590",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Morrissey, DO
• Braeden Moses
• Kalie Irene Mullen, CPNP
• Alice Murphy, RN, LPC
• Jeffrey M Noel, O.D.
• North Texas Center for Oral and Maxillofacial Surgery
• Lily Ankrah Obioha
• Similoluwa Olutomiwa Olushola
• Charles Okechukwu Onyeama, M.D.
• Robert Lamar Owsley, D.D.S.

• Orthopaedic Surgery Physician in Trophy Club, TX
• Providers in Trophy Club, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.