Active NPI
Extended Hands Senior Care LLC
- Gerontology Nurse Practitioner
- Fort Worth, TX
National Provider Identifier
1639029580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- Legal business name
- EXTENDED HANDS SENIOR CARE LLC
- Practice address
- 3425 Sycamore School Rd Ste 101
Fort Worth, TX 76123-3030 - Phone
- (469) 915-4211
- NPI assigned
- Jan 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Al Berry
- Title
- Manager
- Phone
- (469) 915-4211
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | Primary |
Addresses
Primary practice location
3425 Sycamore School Rd Ste 101
Fort Worth, TX 76123-3030
Mailing address
3425 Sycamore School Rd Ste 101
Fort Worth, TX 76123-3030
Phone (469) 915-4211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3425 Sycamore School Rd
Ste 101
Fort Worth, TX 76123
Phone (682) 470-7636
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Waxahachie, TX
- NPI 1932985496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1769731200000",
"number": "1639029580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3425 SYCAMORE SCHOOL RD STE 101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761233030",
"telephone_number": "469-915-4211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3425 SYCAMORE SCHOOL RD STE 101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761233030",
"telephone_number": "469-915-4211"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXTENDED HANDS SENIOR CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-01-30",
"last_updated": "2026-01-30",
"certification_date": "2026-01-30",
"status": "A",
"authorized_official_last_name": "BERRY",
"authorized_official_first_name": "AL",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "469-915-4211"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": null,
"license": null,
"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 Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.