Active NPI
Kim Alan Foreman, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Tyler, TX
National Provider Identifier
1245228550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- F9435
- Practice address
- 8101 S Broadway Ave
Suite 200
Tyler, TX 75703-5469 - Phone
- (903) 561-2495
- Fax
- (800) 848-0426
- NPI assigned
- Oct 11, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | F9435 | TX | Primary |
Addresses
Primary practice location
8101 S Broadway Ave
Suite 200
Tyler, TX 75703-5469
Mailing address
PO Box 130189
Tyler, TX 75713-0189
Phone (903) 939-7551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F9435 | TX | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ortholonestar, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Houston, TX
- NPI 1942860176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421798400000",
"number": "1245228550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130189",
"city": "TYLER",
"state": "TX",
"postal_code": "757130189",
"telephone_number": "903-939-7551",
"fax_number": "903-592-6906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8101 S BROADWAY AVE",
"address_2": "SUITE 200",
"city": "TYLER",
"state": "TX",
"postal_code": "757035469",
"telephone_number": "903-561-2495",
"fax_number": "800-848-0426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOREMAN",
"first_name": "KIM",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2015-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "TX",
"license": "F9435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.