RS5 Medical PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

RS5 MEDICAL PLLC

Practice address

4444 Heritage Trace Pkwy, Ste 408
Fort Worth, TX 76244

Phone

(817) 283-5252

NPI assigned

Dec 11, 2020

Organization subpart

No

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

Authorized official

Name

Larry M Kjeldgaard, DO

Title

Owner / President

Phone

(817) 283-5252

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1972109148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 HERITAGE TRACE PKWY, STE 408",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-283-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 HERITAGE TRACE PKWY, STE 408",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-283-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RS5 MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "KJELDGAARD",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "817-283-5252",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jimmyd@trinityorthopedics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "4444 Heritage Trace Pkwy, Ste 408",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.