Active NPI
Rachel Marie Fanous, CNM
- Advanced Practice Midwife
- Fort Worth, TX
National Provider Identifier
1609169085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- AP120600
- Practice address
- 1500 S Main St
Fort Worth, TX 76104-4917 - Phone
- (817) 702-6500
- Fax
- (817) 927-3872
- NPI assigned
- May 18, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 718375 | TX | |
| Advanced Practice Midwife | 367A00000X | AP120600 | TX | Primary |
Addresses
Primary practice location
1500 S Main St
Fort Worth, TX 76104-4917
Mailing address
PO Box 732973
Dallas, TX 75373-2973
Phone (817) 702-2450
Other practice location 1
855 Montgomery St
Dept of OB/GYN
Fort Worth, TX 76107-2553
Phone (817) 920-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287016403 | Medicaid | TX | |
| 8105NS | Other | TX | BCBS |
Other names 1
- Rachel Marie Zimmer
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
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 718375 | TX | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1609169085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 732973",
"city": "DALLAS",
"state": "TX",
"postal_code": "753732973",
"telephone_number": "817-702-2450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 S MAIN ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044917",
"telephone_number": "817-702-6500",
"fax_number": "817-927-3872"
}
],
"practiceLocations": [
{
"address_1": "855 Montgomery St",
"address_2": "Dept of OB/GYN",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761072553",
"country_code": "US",
"telephone_number": "817-920-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FANOUS",
"first_name": "RACHEL",
"middle_name": "MARIE",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "TX",
"license": "718375",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "TX",
"license": "AP120600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "287016403",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8105NS",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RACHEL",
"last_name": "ZIMMER",
"middle_name": "MARIE",
"credential": "CNM",
"code": "1",
"type": "Former Name"
}
]
}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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.