NPIMap

Organization Active NPI

Cook Children's Medical Center

  • Children's Hospital
  • Fort Worth, TX
National Provider Identifier
1891765178
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
000332 Issued in TX
Legal business name
COOK CHILDREN'S MEDICAL CENTER
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-4000
Fax
(682) 885-1903
NPI assigned
Jan 26, 2006
Last updated
Oct 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Cory R Rhoades
Title
Chief Financial Officer
Phone
(682) 885-4480

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
Rehabilitation Hospital Unit 273Y00000X 000332 TX
Children's Hospital 282NC2000X 000332 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 99213
Fort Worth, TX 76199-0213
Phone (682) 885-1860

Other practice location 1

750 Mid Cities Blvd Ste 110
Hurst, TX 76054-2793
Phone (817) 581-2794

Other practice location 2

801 Matlock Rd
Mansfield, TX 76063-9174
Phone (682) 885-2200

Other practice location 3

13340 Highland Hills Dr Ste 111
Aledo, TX 76008-2000
Phone (817) 347-2983

Other practice location 4

1719 8th Ave
Fort Worth, TX 76110-1349
Phone (682) 885-4063

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cookchildrens@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080909000374 TX Part A Provider - Hospital 5597757740 4 other NPIs on this enrollment
Practice locations: Fort Worth, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1891765178. Details of each certification follow.

Hospital certification: CCN 453300

Legal name
COOK CHILDREN'S MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Oct 1, 1983
Last certification
Mar 12, 2025
Beds
462
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 25, 1985 in TX
Enrollment address
801 7TH Ave
Fort Worth, TX 76104-2733
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Children’s

Hospital certification: CCN 459812

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COOK CHILDRENS MEDICAL CENTER TRANSPLANT SERVICES
Certification status
Active
Provider type (POS)
Hospital – Transplant
Participating since
Dec 1, 2008
Last certification
Dec 6, 2021
Facility address
801 Seventh Ave
Fort Worth, TX 76104

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Cook Childrens Medical CenterCCN 453300 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Cook Childrens Mobile E25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

7000 Calmont Ave
#2
Fort Worth, TX 76116
Phone (682) 885-4061

1719 8th Ave
Ft Worth, TX 76110
Phone (682) 885-4063

750 Mid Cities Blvd
Ste 110
Hurst, TX 76054
Phone (817) 347-2955

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew S Wayne Individual Corporate OfficerVice Chairman/Board Member Jun 1, 2024
William Walton Jones Individual Corporate OfficerBoard Member Jun 1, 2019
Jeffrey L Cureton Individual Corporate OfficerBoard Member Jun 1, 2019
Laura S Miller Individual Corporate OfficerBoard Member Jun 1, 2022
Bonnie Petsche Individual Corporate OfficerBoard Member Jun 1, 2021
Ryan B Dickerson Individual Corporate OfficerBoard Member Jun 1, 2019
John P Boswell Individual Corporate DirectorSecretary/Treasurer Jun 1, 2023
Thomas Breckinridge Ray Individual Corporate OfficerBoard Member Jun 1, 2023
Michael a Lagatta Individual Corporate OfficerBoard Member Jun 1, 2019
NA'Im Moses Individual Corporate OfficerBoard Member Jun 1, 2024
Edwin S Ryan Individual Corporate OfficerBoard Member Jun 1, 2023
Cook Childrens Healthcare System Organization, Fort Worth, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 26, 1998
Cory Rhoades Individual Corporate OfficerChief Financial Officer Oct 1, 2019 75%
Terri Von Lehmden Individual Corporate OfficerBoard Member Jun 1, 2025
Peggy L Cassidy Individual Corporate OfficerBoard Member Jun 1, 2023
Kristy Smith Individual W-2 Managing Employee Jun 13, 2008
Tashanna T Oneal Individual W-2 Managing EmployeePayor Relations Analyst May 24, 2019

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 158

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.

View all 158

Affiliated clinicians 86

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1891765178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-1860",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-4000",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Mid Cities Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Hurst",
            "state": "TX",
            "postal_code": "760542793",
            "country_code": "US",
            "telephone_number": "817-581-2794",
            "fax_number": "817-656-3659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Matlock Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760639174",
            "country_code": "US",
            "telephone_number": "682-885-2200",
            "fax_number": "682-518-8383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13340 Highland Hills Dr Ste 111",
            "address_purpose": "LOCATION",
            "city": "Aledo",
            "state": "TX",
            "postal_code": "760082000",
            "country_code": "US",
            "telephone_number": "817-347-2983",
            "fax_number": "682-885-6439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1719 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761101349",
            "country_code": "US",
            "telephone_number": "682-885-4063",
            "fax_number": "682-885-1878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COOK CHILDREN'S MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "RHOADES",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "682-885-4480"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "TX",
            "license": "000332",
            "primary": false
        },
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "TX",
            "license": "000332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cookchildrens@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.