Medical Edge Healthcare Group PA

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDICAL EDGE HEALTHCARE GROUP PA

Doing business as

Kyle Hoogendoorn DPM

Practice address

1001 12TH Ave Ste 160
Fort Worth, TX 76104-3926

Phone

(817) 336-1189

Fax

(817) 877-5665

NPI assigned

Mar 20, 2009

Organization subpart

No

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

Authorized official

Name

Clay Heighten

Title

President

Phone

(972) 739-3001

Specialties & licenses 1

Addresses

Other names 1

• Kyle Hoogendoorn DPM Doing business as

Locations

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1780825794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 160",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-336-1189",
            "fax_number": "817-877-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 160",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-336-1189",
            "fax_number": "817-877-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDGE HEALTHCARE GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "HEIGHTEN",
        "authorized_official_first_name": "CLAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-739-3001"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kyle Hoogendoorn DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.