Organization Active NPI

Arapaho Village Medical Association

  • Family Medicine Physician
  • Richardson, TX
National Provider Identifier
1487771523
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARAPAHO VILLAGE MEDICAL ASSOCIATION
Practice address
403 W Campbell Rd
Suite 103
Richardson, TX 75080-3465
Phone
(972) 235-8311
Fax
(972) 235-2663
NPI assigned
Mar 23, 2007
Last updated
Aug 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Pat Ross
Title
Accounting
Phone
(972) 235-8311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

403 W Campbell Rd
Suite 103
Richardson, TX 75080-3465

Mailing address

403 W Campbell Rd
Suite 103
Richardson, TX 75080-3465
Phone (972) 235-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100907000525 TX Part B Supplier - Clinic/Group Practice 7012031511 Receives reassigned benefits from 3 practitioners
Practice locations: Richardson, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0477769Arapaho Village Medical Association403 West Campbell Suite 103, Richardson, TX 75080Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory

Locations

403 W Campbell Rd
Ste 103
Richardson, TX 75080
Phone (972) 235-8311

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1487771523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W CAMPBELL RD",
            "address_2": "SUITE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803465",
            "telephone_number": "972-235-8311",
            "fax_number": "972-235-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W CAMPBELL RD",
            "address_2": "SUITE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803465",
            "telephone_number": "972-235-8311",
            "fax_number": "972-235-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARAPAHO VILLAGE MEDICAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ACCOUNTING",
        "authorized_official_telephone_number": "972-235-8311"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.