Individual provider Active NPI

Pamela Simpson, PT

  • Specialist
  • Fort Worth, TX
National Provider Identifier
1588078190
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1097848 Issued in TX
Practice address
6850 Manhattan Blvd Ste 204
Fort Worth, TX 76120-1210
Phone
(817) 507-1500
NPI assigned
Jun 12, 2014
Last updated
Jun 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1097848 TX Primary

Addresses

Primary practice location

6850 Manhattan Blvd Ste 204
Fort Worth, TX 76120-1210

Mailing address

6850 Manhattan Blvd Ste 204
Fort Worth, TX 76120-1210
Phone (817) 507-1500

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
1097848TXMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1588078190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 MANHATTAN BLVD STE 204",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761201210",
            "telephone_number": "817-507-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 MANHATTAN BLVD STE 204",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761201210",
            "telephone_number": "817-507-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "PAMELA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "1097848",
            "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 Jun 12, 2014; 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.