NPIMap

Organization Active NPI

Supplemental Health Care

  • Rehabilitation Hospital
  • Fort Worth, TX
National Provider Identifier
1417229972
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
SUPPLEMENTAL HEALTH CARE
Practice address
5601 Bridge St
Suite 490
Fort Worth, TX 76112-2384
Phone
(877) 441-7800
Fax
(877) 441-7802
NPI assigned
Jan 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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

Authorized official

Name
Michelle Martin
Title
Pta
Phone
(806) 236-1553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

5601 Bridge St
Suite 490
Fort Worth, TX 76112-2384

Mailing address

6628 Richardson Dr
Watauga, TX 76148-2335

National Provider Directory

National Provider Directory

Locations

5601 Bridge St
Ste 490
Ft Worth, TX 76112
Phone (817) 446-5000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1417229972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6628 RICHARDSON DR",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761482335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 BRIDGE ST",
            "address_2": "SUITE 490",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122384",
            "telephone_number": "877-441-7800",
            "fax_number": "877-441-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PTA",
        "authorized_official_telephone_number": "806-236-1553"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.