FW Senior Community LTD Co

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FW SENIOR COMMUNITY LTD CO

Practice address

4600 Heritage Trace Pkwy
Fort Worth, TX 76244-8900

Phone

(214) 954-4114

Fax

(214) 871-3057

NPI assigned

Mar 8, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Robin F Underhill

Title

Chief Executive Officer

Phone

(214) 954-4114

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Harrison at Heritage Doing business as

Locations

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1881968808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 GOLDEN BEAR DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750062377",
            "telephone_number": "214-954-4114",
            "fax_number": "214-871-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 HERITAGE TRACE PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448900",
            "telephone_number": "214-954-4114",
            "fax_number": "214-871-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FW SENIOR COMMUNITY LTD CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "UNDERHILL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-954-4114",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020452",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Harrison at Heritage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamara Kay Futrell, MS,RD,LD,CNSC,CCTD
• FW Hearing LLC
• FW Imaging
• FW Interventional Pain Center, LLC
• FW NMC, PA
• FW Specialty Surgicare, LLC
• FWM Healthcare, LLC Dba Ft. Worth Manor
• FWS PLLC.
• Fyatt Healthcare
• G Ives Nutrition Therapy LLC

• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.