Premier Orthopedics of Fort Worth, PA

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

PREMIER ORTHOPEDICS OF FORT WORTH, PA

Practice address

6930 Harris Pkwy Ste 130
Fort Worth, TX 76132-4272

Phone

(817) 632-0020

Fax

(817) 632-0022

NPI assigned

May 31, 2012

Last updated

May 28, 2024By 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

Sonja Manning

Title

Medical Office Support

Phone

(817) 632-0020

Specialties & licenses 1

Addresses

Other names 2

• Kraig R Pepper DO PA Former legal business name
• Kraig R. Pepper, D.O., P.A. Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Baylor Surgicare at Granbury LLC

  dba Baylor Scott & White Surgicare-Granbury

  • Ambulatory Surgical Clinic/Center
  • Granbury, TX
  • NPI 1386882587

  Member Of

  NPD member
• Fort Worth Surgicare Partners, LTD.

  dba Baylor Scott & White Surgical Hospital - Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871599183

  Member Of

  NPD member

Locations

Practitioners 6

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.

• Kraig Robert Pepper, DO PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fort Worth, TX
  • NPI 1568444107
  Medicare reassignment Care Compare group NPD
• Robert Martin, PA-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1205233020
  Medicare reassignment Care Compare group
• Lyndi Armstrong, APRN-CNP

  • Family Nurse Practitioner
  • Granbury, TX
  • NPI 1548870959
  NPD (past)
• John Everett Carter, PA-C

  • Physician Assistant
  • Granbury, TX
  • NPI 1780681486
  NPD (past)
• Summer D Cumba, PA

  • Medical Physician Assistant
  • Granbury, TX
  • NPI 1104927136
  NPD (past)
• Ginger Suzanne Goodchild, D.O.

  • Family Medicine Physician
  • Granbury, TX
  • NPI 1306894894
  NPD (past)

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1851652457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 HARRIS PARKWAY",
            "address_2": "SUITE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-632-0020",
            "fax_number": "817-632-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 HARRIS PKWY STE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324272",
            "telephone_number": "817-632-0020",
            "fax_number": "817-632-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ORTHOPEDICS OF FORT WORTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "SONJA",
        "authorized_official_title_or_position": "MEDICAL OFFICE SUPPORT",
        "authorized_official_telephone_number": "817-632-0020"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kraig R Pepper DO PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Kraig R Pepper DO PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Kraig R. Pepper, D.O., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Samuel G Preece II, DDS
• Preferred Imaging of Fort Worth LLC
• Sara Kathleen Preisendanz, MS, RD, LD
• Garrick C Prejean, M.D.
• Premier Neuro Diagnostics LLC
• Premier Rehab Physical Therapy and Aquatics
• Premise Health of Texas Medical PA (Trinity Metro Medical Clinic)
• Premise Health of Texas Medical PA (Premise Health Clinic)
• Premise Health of Texas Medical, P.a (The Wellness Center powered by Premise Health)
• Andrea Prempeh

• Sports Medicine (Orthopaedic Surgery) Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.