Purple Amphibian, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

648218 Issued in TX

Legal business name

PURPLE AMPHIBIAN, LLC

Practice address

7451 Chapel Ave
Fort Worth, TX 76116-7090

Phone

(817) 926-2544

NPI assigned

Aug 5, 2008

Organization subpart

No

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

Authorized official

Name

Cece J Pannell

Title

Office Manager

Phone

(817) 294-7444

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1881850295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2626",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132626",
            "telephone_number": "817-294-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 CHAPEL AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167090",
            "telephone_number": "817-926-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPLE AMPHIBIAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "PANNELL",
        "authorized_official_first_name": "CECE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-294-7444"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "648218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "0025KE",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Purevoice Therapy PLLC
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• Paulina Purnama, PA-C
• Clendon Henry Purnell Jr., LPC
• Purple Hearts Transportation LLC
• Purpose of Life Homecare
• Colton Purscell, DC
• Pursuit of Healthyness, PLLC
• Rohit Venkat Puskoor, M.D.

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.