Fort Worth Northside Community Health Center

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

FORT WORTH NORTHSIDE COMMUNITY HEALTH CENTER

Practice address

2106 N. Main
Fort Worth, TX 76106-8570

Phone

(817) 625-4254

NPI assigned

May 24, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Eddy L. Herrera, MSSW

Title

Chief Executive Officer

Phone

(817) 378-0855

Specialties & licenses 1

Addresses

Other names 1

• FWNCHC Other name

Tax ID family

North Texas Area Community Health Centers Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• North Texas Area Community Health Centers, Inc

  dba Southeast Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Fort Worth, TX
  • NPI 1700192085
  NPD tax ID
• North Texas Area Community Health Centers, Inc

  dba Arlington Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Arlington, TX
  • NPI 1740668011
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Zenaida P Racasa-Aliyas, MD

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1720160351
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730182585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST",
            "address_2": "STE 215",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761068576",
            "telephone_number": "817-378-0855",
            "fax_number": "817-378-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 N. MAIN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761068570",
            "telephone_number": "817-625-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH NORTHSIDE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERRERA",
        "authorized_official_first_name": "EDDY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "817-378-0855",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSSW"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FWNCHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fort Worth Med-Peds Associates P.a.
• Fort Worth Medical Associates, PLLC
• Fort Worth Medical Specialists PLLC
• Fort Worth Medtex LP (Medtex of Fort Worth)
• Fort Worth Midwives LLC
• Fort Worth Nursing & Rehabilitation Center
• Fort Worth Occmed, LLC (Occupational Health Solutions)
• Fort Worth Orthopedic Surgery & Sports Medicine, P.a.
• Fort Worth Osteopathc Hospital, Inc. (Osteopathic Medical Center of Texas)
• Fort Worth Pain Management Center LLC

• Voluntary or Charitable Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Voluntary or Charitable Agency in Texas

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.