Amelia Kharman Villagomez, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R8127 Issued in TX

Practice address

1001 12TH Ave Ste 174
Fort Worth, TX 76104-3927

Phone

(682) 200-1744

Fax

(682) 478-5487

NPI assigned

Nov 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Connections Southernaz, LLC Outpatient

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1669890836
  NPD

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1659553683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 174",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043927",
            "telephone_number": "682-200-1744",
            "fax_number": "682-478-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 174",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043927",
            "telephone_number": "682-200-1744",
            "fax_number": "682-478-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGOMEZ",
        "first_name": "AMELIA",
        "middle_name": "KHARMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "R8127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard M Vigness, M. D.
• Vijyalaxmi Enterprise Inc (Vickery Pharmacy)
• Alexander P. Vilaythong, DO
• Jenny Vilayvanh, LCSW
• Hazel Villa
• Angela Villagomez
• Janet Marquez Villalobos
• Dexie Mallari Villanueva
• Madison Villanueva, LPC, NCC
• Sarah Renea Villanueva

• Psychiatry Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.