NPIMap

Organization Active NPI

Chisholm Trail Orthopedics & Sports Medicine, LLLP

Doing business as Chisholm Trail Orthopedic & Sports Medicine, LLLP

  • Orthopaedic Surgery Physician
  • Cleburne, TX
National Provider Identifier
1821148032
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CHISHOLM TRAIL ORTHOPEDICS & SPORTS MEDICINE, LLLP
Doing business as
Chisholm Trail Orthopedic & Sports Medicine, LLLP
Practice address
2010 W Katherine P Raines Rd
Suite 300
Cleburne, TX 76033-7435
Phone
(817) 556-3212
Fax
(817) 556-2388
NPI assigned
Jan 11, 2007
Last updated
Feb 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Dr. Blaine Lee Farless IX, MDNPI 1881633766
Title
Senior Partner
Phone
(817) 556-3212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

2010 W Katherine P Raines Rd
Suite 300
Cleburne, TX 76033-7435

Mailing address

2010 W Katherine P Raines Rd
Suite 300
Cleburne, TX 76033-7435
Phone (817) 556-3212

Other practice location 1

2010 W Katherine P Raines Rd Ste 400
Cleburne, TX 76033-7458
Phone (817) 556-3212

Other identifiers 1

IdentifierTypeStateIssuer
083406102MedicaidTX

Other names 2

  • Chisholm Trail Orthopedic & Sports Medicine, LLLP Doing business as
  • Cleburne Orthopedic & Sports Medicine Center, LLP Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050427000585 TX Part B Supplier - Clinic/Group Practice 7618916883 Receives reassigned benefits from 13 practitioners
Practice locations: Cleburne, TX; Fort Worth, TX
O20100930059278 TX DME Supplier - Physician - Orthopedic/Orthopedic Surgery 7618916883 Practice locations: Cleburne, TX

National Provider Directory

National Provider Directory

Locations

2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033
Phone (817) 556-3212

5540 Sycamore School Rd
Ste 312
Ft Worth, TX 76123
Phone (817) 556-3212

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1821148032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD",
            "address_2": "SUITE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337435",
            "telephone_number": "817-556-3212",
            "fax_number": "817-556-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD",
            "address_2": "SUITE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337435",
            "telephone_number": "817-556-3212",
            "fax_number": "817-556-2388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 W Katherine P Raines Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Cleburne",
            "state": "TX",
            "postal_code": "760337458",
            "country_code": "US",
            "telephone_number": "817-556-3212",
            "fax_number": "817-645-9845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHISHOLM TRAIL ORTHOPEDICS & SPORTS MEDICINE, LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "FARLESS",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "817-556-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IX",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083406102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chisholm Trail Orthopedic & Sports Medicine, LLLP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chisholm Trail Orthopedic & Sports Medicine, LLLP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cleburne Orthopedic & Sports Medicine Center, LLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.