Fort Worth Pediatrics

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

FORT WORTH PEDIATRICS

Practice address

5708 Edwards Ranch Road
Fort Worth, TX 76109

Phone

(817) 336-4040

Fax

(817) 336-6780

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Diane A Richey

Title

Business Administrator

Phone

(817) 336-4040

Specialties & licenses 1

Addresses

Other identifiers 6

Tax ID family

Fort Worth Pediatrics6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Worth Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Fort Worth, TX
  • NPI 1629300603
  NPD tax ID
• Fort Worth Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Fort Worth, TX
  • NPI 1710219795
  NPD tax ID
• Fort Worth Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Fort Worth, TX
  • NPI 1801128889
  NPD tax ID
• Fort Worth Pediatrics, P.a.

  • Pediatric Adolescent Medicine Physician
  • Fort Worth, TX
  • NPI 1760502835
  NPD tax ID
• Fort Worth Pediatrics, P.a.

  • Pediatric Adolescent Medicine Physician
  • Fort Worth, TX
  • NPI 1972623031
  NPD tax ID

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1407808652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 EDWARDS RANCH ROAD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-336-4040",
            "fax_number": "817-336-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5708 EDWARDS RANCH ROAD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-336-4040",
            "fax_number": "817-336-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "RICHEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "817-336-4040"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8541908",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130900702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10001409",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00L72L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130900703",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130900704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Worth Orthopedic Surgery & Sports Medicine, P.a.
• Fort Worth Osteopathc Hospital, Inc.
• Fort Worth Pain Management Center LLC
• Fort Worth Pediatric Dentistry
• Fort Worth Pediatric Therapy PLLC
• Fort Worth Pediatrics
• Fort Worth Pediatrics
• Fort Worth Pediatrics
• Fort Worth Pediatrics, P.a.
• Fort Worth Pediatrics, P.a.

• Pediatric Adolescent Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Adolescent Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.