NPIMap

Organization Active NPI

Bethesda Foundation

  • Assisted Living Facility
  • Fort Worth, TX
National Provider Identifier
1689715351
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
116869 Issued in TX
Legal business name
BETHESDA FOUNDATION
Practice address
5417 Altamesa Blvd
Fort Worth, TX 76123-2804
Phone
(817) 292-8886
Fax
(817) 292-3128
NPI assigned
Feb 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie Callender
Title
Sr. Vice Pesident
Phone
(719) 481-5481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 116869 TX Primary

Addresses

Primary practice location

5417 Altamesa Blvd
Fort Worth, TX 76123-2804

Mailing address

5417 Altamesa Blvd
Fort Worth, TX 76123-2804
Phone (817) 292-8886

Other names 1

  • Bethesda Gardens Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2233193Bethesda Gardens Fort Worth Assisted Living5417 Altamesa Blvd, Fort Worth, TX 76123Certificate of waiverAug 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bethesda Care Ctrtarkio15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689715351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5417 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232804",
            "telephone_number": "817-292-8886",
            "fax_number": "817-292-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5417 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232804",
            "telephone_number": "817-292-8886",
            "fax_number": "817-292-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALLENDER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "SR. VICE PESIDENT",
        "authorized_official_telephone_number": "719-481-5481"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "116869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethesda Gardens",
            "code": "5",
            "type": "Other 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.