Bethany Wimberly

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R6940 Issued in TX

Practice address

3095 Kingswood Blvd Ste 250
Grand Prairie, TX 75052

Phone

(972) 817-1950

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center at Irving Hospital, Irving, TX, CCN 450079
• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwimberly432301@direct.sw.org

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

• Baylor Medical Center at Irving

  • Psychiatric Hospital Unit
  • Irving, TX
  • NPI 1114268471
  Care Compare affiliation
• Baylor Medical Center at Irving

  • General Acute Care Hospital
  • Irving, TX
  • NPI 1992700983
  Care Compare affiliation
• Bir JV LLP

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1538465901

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1407237316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KINGSWOOD BLVD STE 250",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KINGSWOOD BLVD STE 250",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052",
            "telephone_number": "972-817-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043902",
            "country_code": "US",
            "telephone_number": "817-877-5292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043902",
            "country_code": "US",
            "telephone_number": "817-877-5292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5941 Riverbend Pl",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761121063",
            "country_code": "US",
            "telephone_number": "254-709-2704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIMBERLY",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R6940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwimberly432301@direct.sw.org",
            "affiliation": "N",
            "address_1": "3095 Kingswood Blvd Ste 250",
            "city": "Grand Prairie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tamela Matrice Williams, RN
• Harold Willis
• April Dawn Wilson
• Kacey Wilson, PTA
• Wilve Home Healthcare , LLC
• Jennifer Christine Winchester, MD
• Ashley Anthony Winters, LMSW
• Titilope Odunmorayo Witemire
• WM Wellness LLC
• Brenna Wolfskill, RD, LD

• Family Medicine Physician in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.