Active NPI
Kevin Rickwartz, M.D.
- Emergency Medicine Physician
- Amarillo, TX
National Provider Identifier
1285715110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- K9646
- Practice address
- 1501 S Coulter St
Amarillo, TX 79106-1770 - Phone
- (806) 354-1000
- NPI assigned
- Oct 18, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | K9646 | TX | Primary |
Addresses
Primary practice location
1501 S Coulter St
Amarillo, TX 79106-1770
Mailing address
PO Box 24691
Fort Worth, TX 76124-1691
Phone (817) 451-4208
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037648501 | Medicaid | TX | |
| 68773889 | Medicaid | NM | |
| 200033600A | Medicaid | OK | |
| 81125S | Other | TX | BLUE CROSS & BLUE SHIELD |
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 |
|---|---|---|---|
| K9646 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stuttgart Regional Medical Center | Past | Accepting new patients | |
| Stuttgart Regional Medical Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Stuttgart, AR
- NPI 1306921747
-
- Certified Registered Nurse Anesthetist
- Stuttgart, AR
- NPI 1316955891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1285715110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24691",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761241691",
"telephone_number": "817-451-4208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S COULTER ST",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791061770",
"telephone_number": "806-354-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKWARTZ",
"first_name": "KEVIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "K9646",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037648501",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "68773889",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200033600A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "81125S",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.