NPIMap

Organization Active NPI

Cook Children's Medical Center

Doing business as Cook Children's Neurosciences

  • Clinical Neuropsychologist
  • Fort Worth, TX
National Provider Identifier
1215236245
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
000332 Issued in TX
Legal business name
COOK CHILDREN'S MEDICAL CENTER
Doing business as
Cook Children's Neurosciences
Practice address
1500 Cooper St
4TH Floor
Fort Worth, TX 76104-2710
Phone
(682) 885-2500
Fax
(682) 885-1903
NPI assigned
Mar 16, 2011
Last updated
Mar 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COOK CHILDREN'S MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Cory R Rhoades
Title
Cfo, Cchcs
Phone
(682) 885-4480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 000332 TX
Clinical Neuropsychologist 103G00000X 000332 TX Primary

Addresses

Primary practice location

1500 Cooper St
4TH Floor
Fort Worth, TX 76104-2710

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-4871

Other names 1

  • COOK CHILDREN'S NEUROSCIENCES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180709002867 TX Part B Supplier - Clinic/Group Practice 5597757740 Receives reassigned benefits from 30 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southlake, TX; Hurst, TX; Fort Worth, TX; Denton, TX

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cook Fort Worth Childre25 organizations share this tax ID, including this one
Part of
Cook Fort Worth Childre

Other organizations with this tax ID 24

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

View all 24

Locations

1500 Cooper St
Fl 4
Fort Worth, TX 76104
Phone (682) 885-1480

750 Mid Cities Blvd
Hurst, TX 76054
Phone (817) 347-2990

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1215236245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-4871",
            "fax_number": "682-885-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COOPER ST",
            "address_2": "4TH FLOOR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042710",
            "telephone_number": "682-885-2500",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK CHILDREN'S MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOK CHILDREN'S MEDICAL CENTER",
        "enumeration_date": "2011-03-16",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "RHOADES",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO, CCHCS",
        "authorized_official_telephone_number": "682-885-4480"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "000332",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "000332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COOK CHILDREN'S NEUROSCIENCES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COOK CHILDREN'S NEUROSCIENCES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 9, 2021; 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.