Fort Physicians & Professionals PLLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

Legal business name

FORT PHYSICIANS & PROFESSIONALS PLLC

Practice address

5833 Oak Bend Trail
Fort Worth, TX 76132-3900

Phone

(817) 678-7428

Fax

(682) 707-5750

NPI assigned

Apr 13, 2020

Organization subpart

No

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

Authorized official

Name

Alice Ann Kuchinskas

Title

Payer Relations

Phone

(562) 544-7823

Specialties & licenses 4

Addresses

Tax ID family

Fort Physicians Professionals PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fort Physicians & Professionals PLLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Fort Worth, TX
  • NPI 1942839113
  NPD tax ID

Locations

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1750900478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 OAKMONT BLVD.",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323900",
            "telephone_number": "625-447-8235",
            "fax_number": "949-485-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5833 OAK BEND TRAIL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323900",
            "telephone_number": "817-678-7428",
            "fax_number": "682-707-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PHYSICIANS & PROFESSIONALS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "KUCHINSKAS",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PAYER RELATIONS",
        "authorized_official_telephone_number": "562-544-7823"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Sue Forrester, CPNP
• Alyssa Nicole Forsyth
• Fort Austin Limited Partnership
• Fort Healthcare LLC
• Fort Healthcare LLC
• Fort Physicians & Professionals PLLC
• Fort Wellness, PLLC
• Fort Worth Allergy and Asthma Associates, LLP
• Fort Worth Birthing & Wellness Center
• Fort Worth Brain & Spine Institute, LLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.