NPIMap

Individual provider Active NPI

Kimberly T Eden, MD

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1568411684
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K7726 Issued in TX
Practice address
5701 Bryant Irvin Rd
Suite 301
Fort Worth, TX 76132-4029
Phone
(817) 361-6200
Fax
(817) 361-6201
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K7726 TX Primary

Addresses

Primary practice location

5701 Bryant Irvin Rd
Suite 301
Fort Worth, TX 76132-4029

Mailing address

5701 Bryant Irvin Rd
Suite 301
Fort Worth, TX 76132-4029
Phone (817) 361-6200

Other identifiers 2

IdentifierTypeStateIssuer
143777402MedicaidTX
8706B6OtherTXBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address keden225150@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000448 TX Practitioner - Family Practice 5496882193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2035 Fort Worth Hwy
Suite 100
Weatherford, TX 76086-4783
Phone (817) 594-0496

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

5701 Bryant Irvin Rd
Fort Worth, TX 76132-4027

Hospital & facility affiliations

  • Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779
  • Medical City Weatherford Hospital, Weatherford, TX, CCN 450203
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Lake Granbury Medical Center Hospital, Granbury, TX, CCN 450596
  • Medical City Arlington Hospital, Arlington, TX, CCN 450675
  • Baylor Institute for Rehabilitation at Fort Worth Inpatient rehabilitation facility, Fort Worth, TX, CCN 673035
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K7726TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Dec 23, 2001 Accepting new patients
Healthtexas Provider Network CurrentSince Dec 23, 2001 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

5701 Bryant Irvin Rd
Ste 301
Ft Worth, TX 76132
Phone (817) 346-4242

Interoperability endpoints

  • Direct secure messaging: kimberly.eden.1@19934.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1568411684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD",
            "address_2": "SUITE 301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324029",
            "telephone_number": "817-361-6200",
            "fax_number": "817-361-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRYANT IRVIN RD",
            "address_2": "SUITE 301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324029",
            "telephone_number": "817-361-6200",
            "fax_number": "817-361-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEN",
        "first_name": "KIMBERLY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K7726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143777402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8706B6",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keden225150@direct.sw.org",
            "affiliation": "N",
            "address_1": "5701 Bryant Irvin Rd",
            "address_2": "Suite 301",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761324029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.