Advanced Medical of North Texas PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ADVANCED MEDICAL OF NORTH TEXAS PLLC

Practice address

5500 N Tarrant Pkwy Ste 108
Fort Worth, TX 76244-5392

Phone

(817) 605-9500

Fax

(817) 605-9503

NPI assigned

Feb 5, 2021

Last updated

Feb 5, 2021By 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. Spencer ShanleyNPI 1437482031

Title

Owner

Phone

(817) 605-9500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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.

• Spencer Charles Shanley, D.C.

  • Chiropractor
  • Fort Worth, TX
  • NPI 1437482031
  Medicare reassignment NPD Authorized official
• Sandia Venord

  • Primary Care Nurse Practitioner
  • Fort Worth, TX
  • NPI 1124783642
  Medicare reassignment NPD
• Melissa D Holland, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Dallas, TX
  • NPI 1215340831
  NPD

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1871185306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 N TARRANT PKWY STE 108",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445392",
            "telephone_number": "817-605-9500",
            "fax_number": "817-605-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 N TARRANT PKWY STE 108",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445392",
            "telephone_number": "817-605-9500",
            "fax_number": "817-605-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL OF NORTH TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "SHANLEY",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-605-9500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced E.C.P., P.a.
• Advanced Eye Care of Texas PLLC
• Advanced Glaucoma Diagnostic and Treatment Center, P.a.
• Advanced Hearing Aid Center
• Advanced Loving Home Care LLC
• Advanced Metabolism Care Associates (Trina Health Of North Texas)
• Advanced Neurological Services (Advanced Therapy Services)
• Advanced Neurological Services LLC (Advanced Therapy Services)
• Advanced Restorative Health, PLLC
• Advanced Visioncare of Fort Worth PA

• General Practice Physician in Fort Worth, TX
• Providers in Fort Worth, 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 Feb 5, 2021; 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.