Organization Active NPI

CD Urgent Care Center 5, PLLC

  • Urgent Care Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1407224850
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CD URGENT CARE CENTER 5, PLLC
Practice address
3020 W 7TH St
Suite 210
Fort Worth, TX 76107-9202
Phone
(214) 871-7000
Fax
(214) 871-7020
NPI assigned
Sep 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Authorized official

Name
Dr. Brenna J Nance, M.D.NPI 1114903150
Title
Managing Partner
Phone
(214) 404-1958

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

3020 W 7TH St
Suite 210
Fort Worth, TX 76107-9202

Mailing address

2807 Allen St
PMB 420
Dallas, TX 75204-1031
Phone (214) 871-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160225000180 TX Part B Supplier - Clinic/Group Practice 5698070928 Receives reassigned benefits from 52 practitioners
Practice locations: Fort Worth, TX

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
45D2104806CD Urgent Care Center 53020 W 7TH Street, Suite 210, Fort Worth, TX 76107Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory

Locations

2909 McKinney Ave
Ste B
Dallas, TX 75204
Phone (214) 871-7000

3116 W 6th St
Ste 100
Fort Worth, TX 76107

Practitioners & affiliated clinicians

Practitioners 79

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

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1407224850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 ALLEN ST",
            "address_2": "PMB 420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041031",
            "telephone_number": "214-871-7000",
            "fax_number": "214-871-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 W 7TH ST",
            "address_2": "SUITE 210",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761079202",
            "telephone_number": "214-871-7000",
            "fax_number": "214-871-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CD URGENT CARE CENTER 5, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "NANCE",
        "authorized_official_first_name": "BRENNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "214-404-1958",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.