Individual provider Active NPI

Rathi Fahim

  • Emergency Medicine Physician
  • Live Oak, TX
National Provider Identifier
1215224860
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P9701 Issued in TX
Practice address
12412 Judson Rd
Live Oak, TX 78233-3255
Phone
(210) 757-7000
NPI assigned
Jul 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X P9701 TX Primary
Emergency Medicine Physician 207P00000X 4301098661 MI

Addresses

Primary practice location

12412 Judson Rd
Live Oak, TX 78233-3255

Mailing address

12412 Judson Rd
Live Oak, TX 78233-3255
Phone (210) 757-7000

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-2001

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
I20140819002236 TX Practitioner - Emergency Medicine 1254562960 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098661MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Apr 2, 2022 Accepting new patients
Truepartners Northwest Emergency Associates PLLC Emergency Medicine CurrentSince Aug 23, 2019 Accepting new patients

Locations

1501 S Coulter St
Amarillo, TX 79106
Phone (800) 354-1150

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

5900 Altamesa Blvd
Ft Worth, TX 76132
Phone (817) 433-9100

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

5330 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 877-8000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

6700 W Interstate 10
San Antonio, TX 78201
Phone (210) 575-8289

13434 Nacogdoches Rd
San Antonio, TX 78217
Phone (210) 447-7560

6402 Mallard Mdw
San Antonio, TX 78244
Phone (210) 757-5000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1215224860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333255",
            "telephone_number": "210-757-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333255",
            "telephone_number": "210-757-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHIM",
        "first_name": "RATHI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P9701",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301098661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.