Individual provider Active NPI

Jennifer L Grant, M.D.

  • Surgical Critical Care Physician
  • Fort Worth, TX
National Provider Identifier
1780976167
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
Q9621 Issued in TX
Practice address
1325 Pennsylvania Ave
Fort Worth, TX 76104-2158
Phone
(817) 761-7740
NPI assigned
May 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q9621 TX
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Critical Care Physician 2086S0102X Q9621 TX Primary

Addresses

Primary practice location

1325 Pennsylvania Ave
Fort Worth, TX 76104-2158

Mailing address

Department of Surgery Ut Southwestern Medical Center
5323 Harry Hines Blvd
Dallas, TX 75390-9159
Phone (214) 648-3917

Other practice location 1

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 296-5944

Other names 1

  • Jennifer Bartholomew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170808002978 TX Practitioner - General Surgery 5597036699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Louisville School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1325 Pennsylvania Ave
Suite 690
Fort Worth, TX 76104-2133
Phone (817) 250-7030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q9621TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Surgery CurrentSince Aug 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Texas Health Physicians Group Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2017 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

800 5th Ave
Ste 400
Fort Worth, TX 76104
Phone (817) 702-9100

1325 Pennsylvania Ave
Ste 690
Fort Worth, TX 76104
Phone (817) 761-7740

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: jgrant1798943@direct.texashealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1780976167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF SURGERY UT SOUTHWESTERN MEDICAL CENTER",
            "address_2": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909159",
            "telephone_number": "214-648-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042158",
            "telephone_number": "817-761-7740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 W Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575147",
            "country_code": "US",
            "telephone_number": "773-296-5944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q9621",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "Q9621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BARTHOLOMEW",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.