Chisholm Trail Emergency Center

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

CHISHOLM TRAIL EMERGENCY CENTER

Doing business as

iCare Emergency Room

Practice address

5500 Sycamore School Rd.
Ste. 150
Fort Worth, TX 76123

Phone

(214) 407-8668

Fax

(214) 407-8665

NPI assigned

Dec 21, 2016

Last updated

Dec 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shane Cole, MDNPI 1003947961

Title

Ceo

Phone

(214) 407-8668

Specialties & licenses 1

Addresses

Other names 1

• iCare Emergency Room Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396280756. Details of each certification follow.

• CCN 670184 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 670184

Legal name

ICARE EMERGENCY ROOM

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

Apr 28, 2020

Last certification

Apr 28, 2020

Beds

1

Ownership / control type

Private (not for profit)

Facility address

5500 Sycamore School Rd, Suite 150
Fort Worth, TX 76123

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shane Parker Cole, M.D.

  • Emergency Medicine Physician
  • Arlington, TX
  • NPI 1003947961
  NPD (past) Authorized official

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1396280756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 SYCAMORE SCHOOL RD.",
            "address_2": "STE. 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76123",
            "telephone_number": "214-407-8668",
            "fax_number": "214-407-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 SYCAMORE SCHOOL RD.",
            "address_2": "STE. 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76123",
            "telephone_number": "214-407-8668",
            "fax_number": "214-407-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHISHOLM TRAIL EMERGENCY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-407-8668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iCare Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chiroplus North PC
• Chiropractic Health Center of Grand Prairie LLC
• Chiropractx, PLLC
• Chirotech, Inc (Chirotech Chiropractic)
• Chisholm Trail E-Therapy and Counseling, PLLC
• Chisholm Trail Oral Surgery PLLC
• Chisholm Trail Orthopedics & Sports Medicine, LLLP
• Chisholm Trail Scal LLC (Chisholm Trail Senior Living)
• Allison Gail Chisholm, M.D
• Edward Lee Chisholm, MS, LAT, ATC

• Emergency Care Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.