Fallen Tree Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D9687 Issued in TX

Legal business name

FALLEN TREE CORP

Practice address

11416 Runnel Ridge Rd
Manor, TX 78653-3874

Phone

(512) 760-0666

Fax

(866) 265-1725

NPI assigned

May 10, 2008

Last updated

Sep 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peyton Thompson, MDNPI 1861439069

Title

Owner, President

Phone

(512) 760-0666

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Peyton Thompson, MD

  • General Practice Physician
  • Manor, TX
  • NPI 1861439069

  Family Medicine

  Medicare reassignment NPD Authorized official
• Monette Michelle Schweitzer, FNP

  • Family Nurse Practitioner
  • Rockdale, TX
  • NPI 1871682252
  Medicare reassignment NPD

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1841467727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11416 RUNNEL RIDGE RD",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786533874",
            "telephone_number": "512-760-0666",
            "fax_number": "866-265-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11416 RUNNEL RIDGE RD",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786533874",
            "telephone_number": "512-760-0666",
            "fax_number": "866-265-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLEN TREE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-10",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "PEYTON",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "512-760-0666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "DD9687",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "DD9687",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "D9687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197360401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Manor, TX
• Providers in Manor, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.