Active NPI
Lonnie Woods
- Adult Care Home Facility
- Fort Worth, TX
National Provider Identifier
1619305612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 75-2515490
- Practice address
- 5025 E Berry St
Fort Worth, TX 76119-2239 - Phone
- (217) 277-9516
- Fax
- (214) 277-9516
- NPI assigned
- Oct 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 75-2515490 | TX | Primary |
Addresses
Primary practice location
5025 E Berry St
Fort Worth, TX 76119-2239
Mailing address
914 Belclaire Cir
Cedar Hill, TX 75104-1238
Phone (214) 277-9516
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
| License | State | Type | Specialty |
|---|---|---|---|
| 75-2515490 | TX | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383004800000",
"number": "1619305612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 BELCLAIRE CIR",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751041238",
"telephone_number": "214-277-9516",
"fax_number": "972-291-0032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5025 E BERRY ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761192239",
"telephone_number": "217-277-9516",
"fax_number": "214-277-9516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "LONNIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-29",
"last_updated": "2013-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "TX",
"license": "75-2515490",
"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 Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.