John K Podgore, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D9864 Issued in TX

Practice address

855 Montgomery St
Fort Worth, TX 76107-2553

Phone

(817) 735-2363

Fax

(817) 735-2653

NPI assigned

Apr 17, 2006

Last updated

Feb 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of North Texas Health Science Center at Fort Worth

  • Neuromusculoskeletal Medicine & OMM Physician
  • Fort Worth, TX
  • NPI 1376645564
  NPD

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1407810344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99335",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990335",
            "telephone_number": "817-735-2363",
            "fax_number": "817-735-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2363",
            "fax_number": "817-735-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODGORE",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "D9864",
            "primary": true
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TX",
            "license": "D9864",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "125514303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125514302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "847309",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marian I Pobee, MD
• Gerard Poche, M.D.
• Alan L Podawiltz, DO
• Ankur Poddar, MD
• Gilda Podell, LCDC
• Podiatric Medical Partners of Texas, PA (Glen Beede, DPM PA)
• Podiatric Medical Partners of Texas, PA
• Podiatric Medical Partners of Texas, PA (Gregory A. Jaryga, DPM)
• Podiatric Medical Partners of Texas, PA (Total Family Footcare)
• Susette Christine Poe, LMSW

• Pediatrics Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.