Active NPI
Kerry T. Rhodes, DPM
- Podiatrist
- Fort Worth, TX
National Provider Identifier
1336105394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 1107
- Practice address
- 6080 South Hulen Street
Suite 360 PMB 215
Fort Worth, TX 76132-4810 - Phone
- (682) 205-1427
- Fax
- (817) 887-5837
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 1107 | TX | Primary |
Addresses
Primary practice location
6080 South Hulen Street
Suite 360 PMB 215
Fort Worth, TX 76132-4810
Mailing address
6080 S. Hulen St.
PMB 215 Suite 360
Fort Worth, TX 76132
Phone (817) 239-8880
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092781601 | Medicaid | TX | |
| 112204603 | Medicaid | TX |
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: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060112000814 | TX | Practitioner - Podiatry | 4688659907 | Practice locations: Seymour, TX; Ozona, TX; Crowell, TX; Odessa, TX; Fort Worth, TX; Crowley, TX; Electra, TX; Amarillo, TX… |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.26 of 100
- Quality
- 50.51
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1107 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1336105394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6080 S. HULEN ST.",
"address_2": "PMB 215 SUITE 360",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76132",
"telephone_number": "817-239-8880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6080 SOUTH HULEN STREET",
"address_2": "SUITE 360 PMB 215",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761324810",
"telephone_number": "682-205-1427",
"fax_number": "817-887-5837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHODES",
"first_name": "KERRY",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2022-07-21",
"certification_date": "2022-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "TX",
"license": "1107",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092781601",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112204603",
"state": "TX"
}
],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.