Organization Active NPI

Chisholm Trail Emergency Center

  • Emergency Care Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1396280756
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
CHISHOLM TRAIL EMERGENCY CENTER
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

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

Mailing address

5500 Sycamore School Rd.
Ste. 150
Fort Worth, TX 76123
Phone (214) 407-8668

Other names 1

  • iCare Emergency Room Doing business as

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
45D2131471Icare Emergency Room5500 Sycamore School Road, Fort Worth, TX 76123AccreditationMay 15, 2028

National Provider Directory

National Provider Directory

Locations

5500 Sycamore School Rd
Ste 150
Fort Worth, TX 76123
Phone (682) 707-9707

8533 Brewer Blvd
Fort Worth, TX 76123
Phone (817) 968-1847

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • 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 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.