Individual provider Active NPI

Adam Rutledge Jennings, D.O.

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1821397068
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
559325 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-5613
NPI assigned
Mar 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 559325 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

1500 S. Main St.
Fort Worth, TX 76104
Phone (817) 702-5613

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
I20140910002015 TX Practitioner - Emergency Medicine 0345469011 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 250-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
559325TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group PA Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Wellness & Care Group of Texas, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Dec 1, 2017 Accepting new patients
Emergis ER Coit, LLC Past Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

21175 Tomball Pkwy
Houston, TX 77070
Phone (281) 251-5544

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

22625 State Highway 249
Ste 450
Tomball, TX 77375
Phone (214) 506-1136

Organizations & group practices 5

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": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1821397068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S. MAIN ST.",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-702-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "ADAM",
        "middle_name": "RUTLEDGE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "559325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.