FS Tenant Pool III Trust

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

110390 Issued in TX

Legal business name

FS TENANT POOL III TRUST

Practice address

7831 Park Lane
Dallas, TX 75225-2000

Phone

(214) 369-9902

Fax

(214) 373-1836

NPI assigned

Apr 19, 2006

Organization subpart

Yes

Parent organization

FS TENANT POOL III TRUSTAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other names 1

• Healthcare Center at The Forum at Park Lane Doing business as

Part of

FS Tenant Pool III Trust

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert James Brus, D.O.

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1699745943
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1962467415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7831 PARK LANE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752252000",
            "telephone_number": "214-369-9902",
            "fax_number": "214-373-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7831 PARK LANE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752252000",
            "telephone_number": "214-369-9902",
            "fax_number": "214-373-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FS TENANT POOL III TRUST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FS TENANT POOL III TRUST",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "110390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcare Center at The Forum at Park Lane",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthcare Center at The Forum at Park Lane",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristi Rebekah Frye, PH.D.
• Laura Kathleen Frye, MD
• Lindsay Frye, CRNA
• Frysh Dental Group, PLLC
• Howard Frysh, DDS
• FSC, Inc.
• Ftic Pain Management PLLC
• Lanxin Fu
• Wanti Fu
• Deborah Sotonye Fubara, M.D.

• All providers in Dallas, TX
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.