Individual provider Active NPI

Glenda Marie Kremer, M.D.

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1932239100
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L7783 Issued in TX
Practice address
5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3514
Phone
(817) 334-1400
Fax
(817) 334-1410
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L7783 TX Primary

Addresses

Primary practice location

5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3514

Mailing address

5450 Clearfork Main St Ste 300
Fort Worth, TX 76109-3514
Phone (817) 334-1400

Other practice location 1

909 9th Ave
Suite 300
Fort Worth, TX 76104-3903
Phone (817) 336-7191

Other identifiers 4

IdentifierTypeStateIssuer
197396805MedicaidTX
197396804MedicaidTX
197396806OtherTXMEDICAID OTHER
197396807MedicaidTX

Other names 1

  • Ms. Glenda Marie Amisial Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081008000703 TX Practitioner - Family Practice 6709975964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1412 May St
Fort Worth, TX 76104-7639
Phone (817) 625-8818

7501 Lakeview Pkwy
Suite 130
Rowlett, TX 75088-9324
Phone (972) 463-3100

809 W Randol Mill Rd
Arlington, TX 76012-2507
Phone (817) 460-0257

900 Airport Fwy
Suite 158
Hurst, TX 76054-3253
Phone (817) 514-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas PLLC CurrentSince Sep 8, 2009 Accepting new patients
Medical Clinic of North Texas, PLLC Family Medicine CurrentSince Sep 8, 2009 Accepting new patients
Wellmed Medical Group, PA Family Medicine Past Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

5450 Clearfork Main St
Ste 300
Fort Worth, TX 76109
Phone (817) 334-1400

5450 Clearfork Main St
Ste 430
Fort Worth, TX 76109
Phone (817) 336-7191

1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818

909 9th Ave
Ste 300
Ft Worth, TX 76104
Phone (817) 336-7191

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • Direct secure messaging: glenda.kremer@wellmed.eclinicaldirectplus.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1932239100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093514",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093514",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 9th Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043903",
            "country_code": "US",
            "telephone_number": "817-336-7191",
            "fax_number": "817-877-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREMER",
        "first_name": "GLENDA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L7783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197396805",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197396804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OTHER",
            "identifier": "197396806",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197396807",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "AMISIAL",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.