Active NPI
KND Development 59 LLC
- Hospitalist Physician
- Fort Worth, TX
National Provider Identifier
1265761746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- Legal business name
- KND DEVELOPMENT 59 LLC
- Practice address
- 815 8TH Ave
Fort Worth, TX 76104-2609 - Phone
- (817) 332-4812
- Fax
- (502) 596-4150
- NPI assigned
- Dec 14, 2009
- Last updated
- Jul 1, 2020
- Organization subpart
- Yes
- Parent organization
- KINDRED HEALTHCARE, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda L Fisher
- Title
- DVP Revenue Cycle
- Phone
- (502) 596-7358
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | NU | Primary |
Addresses
Primary practice location
815 8TH Ave
Fort Worth, TX 76104-2609
Mailing address
680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-7358
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TXB109364 | Other | TX | MEDICARE |
Other names 1
- 4668 KH FORTH WORTH
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101013000177 | TX | Part B Supplier - Clinic/Group Practice | 3678602802 |
Receives reassigned benefits from 110 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sugarland, TX; Webster, TX; San Antonio, TX; Manvel, TX; Houston, TX; Fort Worth, TX; El Paso, TX; Dallas, TX… |
Other NPIs on the same Medicare enrollment 17
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Presence Covenant Medical Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1593561600000",
"number": "1265761746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 S 4TH ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402022407",
"telephone_number": "502-596-7358",
"fax_number": "833-501-9731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042609",
"telephone_number": "817-332-4812",
"fax_number": "502-596-4150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KND DEVELOPMENT 59 LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KINDRED HEALTHCARE, INC",
"enumeration_date": "2009-12-14",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A",
"authorized_official_last_name": "FISHER",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "DVP REVENUE CYCLE",
"authorized_official_telephone_number": "502-596-7358"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "TXB109364",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "4668 KH FORTH WORTH",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "4668 KH FORTH WORTH",
"code": "5",
"type": "Other Name"
}
]
}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 Jul 1, 2020; 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.