Individual provider Active NPI

Susan Franks, PHD

  • Clinical Psychologist
  • Fort Worth, TX
National Provider Identifier
1285696658
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
25105 Issued in TX
Practice address
855 Montgomery St
Fort Worth, TX 76107-2553
Phone
(817) 735-2400
Fax
(817) 735-0615
NPI assigned
Apr 3, 2006
Last updated
Oct 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 25105 TX Primary

Addresses

Primary practice location

855 Montgomery St
Fort Worth, TX 76107-2553

Mailing address

PO Box 99335
Fort Worth, TX 76199-0335
Phone (817) 735-2400

Other identifiers 3

IdentifierTypeStateIssuer
680006052OtherTXRAILROAD MEDICARE
81538POtherTXBCBS
038896901MedicaidTX

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100513000467 TX Practitioner - Clinical Psychologist 7113055161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3430 Camp Bowie Blvd
Fort Worth, TX 76107-2729
Phone (817) 735-2273

855 Montgomery St
Fort Worth, TX 76107-2553
Phone (817) 735-5418

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as apm
Quality
76.45
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25105TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Texas Health Science Center at Fort Worth CurrentSince Sep 21, 1994 Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
University of North Texas Health Science Center at Fort Worth CurrentSince Sep 21, 1994 Accepting new patients
University of North Texas Health Science Center at Fort Worth Past Accepting new patients

Locations

3500 Camp Bowie Blvd
Ft Worth, TX 76107
Phone (817) 735-2000

4701 Bryant Irvin Rd N
Ft Worth, TX 76107
Phone (817) 702-7400

855 Montgomery St
Ft Worth, TX 76107
Phone (817) 735-2334

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1285696658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335",
            "telephone_number": "817-735-2400",
            "fax_number": "817-735-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2400",
            "fax_number": "817-735-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKS",
        "first_name": "SUSAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "25105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "680006052",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "81538P",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038896901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.