Individual provider Active NPI

Anthony Eugene Pinckney

  • Assisted Living Facility (Mental Illness)
  • Fort Worth, TX
National Provider Identifier
1487514295
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
001011661 Issued in TX
Practice address
3612 Ada Ave
Fort Worth, TX 76105-3422
Phone
(682) 230-5417
Fax
(817) 547-0023
NPI assigned
Nov 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 001011661 TX
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Assisted Living Facility (Mental Illness) 3104A0625X 001011661 TX Primary
Respite Care 385H00000X 001011661 TX

Addresses

Primary practice location

3612 Ada Ave
Fort Worth, TX 76105-3422

Mailing address

3612 Ada Ave
Fort Worth, TX 76105-3422
Phone (682) 230-5417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001011661TXMDRespite Care

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony E Pinckney Day Training, Developmentally Disabled Services CurrentSince Nov 18, 2025 Accepting new patients

Organizations & group practices 1

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": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1487514295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 ADA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761053422",
            "telephone_number": "682-230-5417",
            "fax_number": "817-547-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 ADA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761053422",
            "telephone_number": "682-230-5417",
            "fax_number": "817-547-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCKNEY",
        "first_name": "ANTHONY",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "TX",
            "license": "001011661",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "TX",
            "license": "001011661",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "TX",
            "license": "001011661",
            "primary": false
        }
    ],
    "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 23, 2026; 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.