Individual provider Active NPI

Jerry Romans

  • Physical Disabilities Residential Treatment Facility
  • Fort Worth, TX
National Provider Identifier
1700065125
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Practice address
5012 Trinity Landing Dr W
Fort Worth, TX 76132-3736
Phone
(817) 701-8642
NPI assigned
Nov 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X TX Primary

Addresses

Primary practice location

5012 Trinity Landing Dr W
Fort Worth, TX 76132-3736

Mailing address

5012 Trinity Landing Dr W
Fort Worth, TX 76132-3736
Phone (817) 701-8642

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

LicenseStateTypeSpecialty
001001925TXMDPhysical Disabilities Residential Treatment Facility

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1700065125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 TRINITY LANDING DR W",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323736",
            "telephone_number": "817-701-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 TRINITY LANDING DR W",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323736",
            "telephone_number": "817-701-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANS",
        "first_name": "JERRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "TX",
            "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 Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.