Individual provider Active NPI

Jennifer Thompson Arnouville, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Fort Worth, TX
National Provider Identifier
1417152000
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
M9812 Issued in TX
Practice address
5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3559
Phone
(817) 334-1400
Fax
(817) 334-1410
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X M9812 TX Primary

Addresses

Primary practice location

5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3559

Mailing address

5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3559
Phone (817) 334-1400

Other practice location 1

800 5th Ave
Ste. 300
Fort Worth, TX 76104-7300
Phone (817) 334-1400

Other identifiers 2

IdentifierTypeStateIssuer
217170402MedicaidTX
217170401MedicaidTX

Other names 1

  • Ms. Jennifer C. Thompson Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101102001149 TX Practitioner - Geriatric MedicinePractitioner - Family Practice 7911191077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
M9812TXMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC CurrentSince Aug 1, 2000 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Aug 1, 2000 Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

5450 Clearfork Main St
Ste 300
Fort Worth, TX 76109
Phone (817) 334-1400

800 5th Ave
Ste 300
Ft Worth, TX 76104
Phone (817) 334-1400

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1417152000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093559",
            "telephone_number": "817-334-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093559",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 5th Ave",
            "address_2": "Ste. 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761047300",
            "country_code": "US",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNOUVILLE",
        "first_name": "JENNIFER",
        "middle_name": "THOMPSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "M9812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217170402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217170401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "THOMPSON",
            "middle_name": "C.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.