NPIMap

Organization Active NPI

Integrated Medical Professionals 1, LTD

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1336160209
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
INTEGRATED MEDICAL PROFESSIONALS 1, LTD
Practice address
2120 Mistletoe Blvd Unit 2
Fort Worth, TX 76110-1174
Phone
(817) 927-8900
Fax
(817) 927-8902
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Ms. Sheri Humphreys
Title
Administrator
Phone
(817) 927-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2120 Mistletoe Blvd Unit 2
Fort Worth, TX 76110-1174

Mailing address

2120 Mistletoe Blvd Unit 2
Fort Worth, TX 76110-1174
Phone (817) 927-8900

Other identifiers 1

IdentifierTypeStateIssuer
00185YOtherTXMEDICARE

Other names 1

  • IMP 1, Ltd Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1336160209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 MISTLETOE BLVD UNIT 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101174",
            "telephone_number": "817-927-8900",
            "fax_number": "817-927-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 MISTLETOE BLVD UNIT 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101174",
            "telephone_number": "817-927-8900",
            "fax_number": "817-927-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL PROFESSIONALS 1, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "HUMPHREYS",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-927-8900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00185Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMP 1, Ltd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 10, 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.

Verify at the official NPI Registry.