Mansfield Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J3502 Issued in TX

Legal business name

MANSFIELD MEDICAL CLINIC

Practice address

1720 E Broad St
Mansfield, TX 76063-3400

Phone

(817) 453-5912

Fax

(817) 453-2988

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James Irvine, D.O

Title

Owner

Phone

(817) 453-5912

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

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

• Jerry Lamont McKenzie, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Mansfield, TX
  • NPI 1053679407
  Medicare reassignment NPD
• Sherri Kirschbaum, FNP

  • Family Nurse Practitioner
  • Mansfield, TX
  • NPI 1023858412
  Medicare reassignment
• Jessica L Ragland, FNP-C

  • Family Nurse Practitioner
  • Mansfield, TX
  • NPI 1518433317
  Medicare reassignment
• Carol A Wood, D.O

  • Family Medicine Physician
  • Mansfield, TX
  • NPI 1942220975
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1407966815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E BROAD ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E BROAD ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633400",
            "telephone_number": "817-453-5912",
            "fax_number": "817-453-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "IRVINE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-453-5912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mansfield Group Health, LLC
• Mansfield HK Group Health, LLC
• Mansfield Interventional Pain Center, LLC
• Mansfield Isd
• Mansfield Long Term Care LLC
• Mansfield Neurology Associates PLLC
• Mansfield Nursing and Rehabilitation LP
• Mansfield OBGYN Association
• Mansfield Oral and Facial Surgery
• Mansfield Pain Services, LLC

• Family Medicine Physician in Mansfield, TX
• Providers in Mansfield, 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 Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.