Individual provider Active NPI

Jamie Marie Underhill, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1508330838
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
669577 Issued in TX
Practice address
4200 South Fwy Ste 100
Fort Worth, TX 76115-1407
Phone
(817) 750-7334
Fax
(817) 910-6120
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 669577 TX Primary

Addresses

Primary practice location

4200 South Fwy Ste 100
Fort Worth, TX 76115-1407

Mailing address

4200 South Fwy Ste 100
Fort Worth, TX 76115-1407
Phone (817) 750-7334

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
669577TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Urgent Care Center of Fort Worth, P.a.. CurrentSince Dec 13, 2022 Accepting new patients
Telemedicine Advantage Concierge Urgent Care CurrentSince Dec 13, 2022 Accepting new patients

Locations

4200 South Fwy
Ste 100
Fort Worth, TX 76115
Phone (817) 750-7334

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1508330838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151407",
            "telephone_number": "817-750-7334",
            "fax_number": "817-910-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151407",
            "telephone_number": "817-750-7334",
            "fax_number": "817-910-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERHILL",
        "first_name": "JAMIE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "669577",
            "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 Dec 6, 2022; 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.