Individual provider Active NPI

Breanne Thomas, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1376215244
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08210178 Issued in TX
Practice address
3308 Deen Rd
Fort Worth, TX 76106-6524
Phone
(817) 702-1100
NPI assigned
Sep 29, 2021
Reactivated
Feb 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08210178 TX Primary

Addresses

Primary practice location

3308 Deen Rd
Fort Worth, TX 76106-6524

Mailing address

200 W Magnolia Ave Ste 201
Fort Worth, TX 76104-7657
Phone (817) 702-2977

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821001816 TX Practitioner - Nurse Practitioner 9739541921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

3308 Deen Rd
Fort Worth, TX 76106-6524
Phone (817) 702-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.38 of 100Reported as group
Quality
80.41
Promoting interoperability
100
Improvement activities
40
Cost
78.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F08210178TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Physician Group, Inc CurrentSince Jul 13, 2023 Accepting new patients

Locations

1050 W Arkansas Ln
Arlington, TX 76013
Phone (817) 277-6555

3200 W Euless Blvd
Euless, TX 76040
Phone (817) 702-6474

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1650 S Beach St
Ft Worth, TX 76105
Phone (817) 702-8647

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

3308 Deen Rd
Ft Worth, TX 76106
Phone (817) 702-1819

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1376215244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 DEEN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761066524",
            "telephone_number": "817-702-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BREANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "deactivation_date": "2021-10-25",
        "reactivation_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F08210178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.