NPIMap

Organization Active NPI

Concentra Worksite of Arizona, PA

Doing business as Aetna Wellness Works Center

  • Health Service Clinic/Center
  • Addison, TX
National Provider Identifier
1326365388
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
CONCENTRA WORKSITE OF ARIZONA, PA
Doing business as
Aetna Wellness Works Center
Practice address
5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-4648
Phone
(972) 364-8000
NPI assigned
Apr 29, 2010
Last updated
Apr 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Dr. William Tom Fogarty, MD
Title
SVP / Chief Medical Officer
Phone
(972) 364-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-4648

Mailing address

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-4648

Other names 1

  • Aetna Wellness Works Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aetna Wellness Works Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1326365388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200W",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200W",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCENTRA WORKSITE OF ARIZONA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TOM",
        "authorized_official_title_or_position": "SVP / CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aetna Wellness Works Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.