Thomas Liles, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP137858 Issued in TX

Practice address

4 Carlson CT
Fort Worth, TX 76119-5901

Phone

(202) 532-3778

NPI assigned

Oct 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1336747963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CWCU",
            "address_2": "4 CARLSON CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76119",
            "telephone_number": "202-532-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARLSON CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761195901",
            "telephone_number": "202-532-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "THOMAS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.