Individual provider Active NPI

Kerry T. Rhodes, DPM

  • Podiatrist
  • Fort Worth, TX
National Provider Identifier
1336105394
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1107 Issued in TX
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

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
092781601MedicaidTX
112204603MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.26 of 100Reported as individual
Quality
50.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1107TXMDBehavioral 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

Verify at the official NPI Registry.