Patricia B Newcomb, PHD RN CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

510094 Issued in TX

Practice address

2528 Jacksboro Hwy
Fort Worth, TX 76114-2206

Phone

(817) 625-1770

Fax

(817) 625-1287

NPI assigned

Jun 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner, Doctor of Philosophy, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD (past)

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1366447013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99371",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990371",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2528 JACKSBORO HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761142206",
            "telephone_number": "817-625-1770",
            "fax_number": "817-625-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "PATRICIA",
        "middle_name": "B",
        "credential": "PHD RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-18",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "510094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "00U87Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN GROUP TPI",
            "identifier": "137345810",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062615204",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1750369203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP TPI",
            "identifier": "140442852",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN INDIVIDUAL TPI",
            "identifier": "062615205",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.