Organization Active NPI

Julie Tomberlin MD PA

  • Pediatric Adolescent Medicine Physician
  • Mansfield, TX
National Provider Identifier
1386943231
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
L3703 Issued in TX
Legal business name
JULIE TOMBERLIN MD PA
Practice address
706 Hunters Row CT
Mansfield, TX 76063-4001
Phone
(682) 518-8111
Fax
(682) 518-8112
NPI assigned
Mar 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Authorized official

Name
Mrs. Julie Ann Tomberlin, MD
Title
Owner
Phone
(682) 518-8111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X L3703 TX Primary

Addresses

Primary practice location

706 Hunters Row CT
Mansfield, TX 76063-4001

Mailing address

706 Hunters Row CT
Mansfield, TX 76063-4001
Phone (682) 518-8111

Other identifiers 1

IdentifierTypeStateIssuer
1396715215OtherTYPE 1 NPI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1007886Julie Tomberlin, MD706 Hunters Row CT, Mansfield, TX 76063Certificate of waiverJan 5, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1386943231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 HUNTERS ROW CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634001",
            "telephone_number": "682-518-8111",
            "fax_number": "682-518-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 HUNTERS ROW CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634001",
            "telephone_number": "682-518-8111",
            "fax_number": "682-518-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE TOMBERLIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "TOMBERLIN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-518-8111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "L3703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1396715215",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.