Organization Active NPI

Christian Care House Calls LLC

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1275901340
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P2012 Issued in TX
Legal business name
CHRISTIAN CARE HOUSE CALLS LLC
Practice address
135 Treetop Dr
Fort Worth, TX 76126-5587
Phone
(817) 372-9200
NPI assigned
Sep 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Authorized official

Name
Donald Webster
Title
Partner / Director of Marketing
Phone
(817) 629-2258

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X P2012 TX Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 617313 TX

Addresses

Primary practice location

135 Treetop Dr
Fort Worth, TX 76126-5587

Mailing address

PO Box 761
Aledo, TX 76008-0761
Phone (817) 372-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151104000587 TX Part B Supplier - Clinic/Group Practice 0244540284 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Worth, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2103398Christian Care House Calls, LLC135 Treetop Drive, Fort Worth, TX 76126Certificate of waiverOct 11, 2027

National Provider Directory

National Provider Directory

Locations

7204 Highway 287
Arlington, TX 76001
Phone (817) 563-6287

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1275901340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760080761",
            "telephone_number": "817-372-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 TREETOP DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761265587",
            "telephone_number": "817-372-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN CARE HOUSE CALLS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PARTNER / DIRECTOR OF MARKETING",
        "authorized_official_telephone_number": "817-629-2258"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P2012",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "617313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.