Organization Active NPI

Keith W Louden M D PA

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1982602611
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
K2062 Issued in TX
Legal business name
KEITH W LOUDEN M D PA
Practice address
5632 Edwards Ranch Rd.
Suite 100
Fort Worth, TX 76109
Phone
(817) 336-7188
Fax
(844) 231-8865
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Keith Ward Louden, MDNPI 1811995541
Title
Physician
Phone
(817) 336-7188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X K2062 TX Primary

Addresses

Primary practice location

5632 Edwards Ranch Rd.
Suite 100
Fort Worth, TX 76109

Mailing address

5632 Edwards Ranch Rd.
Suite 100
Fort Worth, TX 76109
Phone (817) 336-7188

Other identifiers 1

IdentifierTypeStateIssuer
153023001MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071101000676 TX Part B Supplier - Clinic/Group Practice 2264529593 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

1308 Paluxy Rd
Ste 205
Granbury, TX 76048
Phone (817) 489-7450

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1982602611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5632 EDWARDS RANCH RD.",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-336-7188",
            "fax_number": "844-231-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 EDWARDS RANCH RD.",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-336-7188",
            "fax_number": "844-231-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH W LOUDEN M D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "LOUDEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "WARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-336-7188",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "K2062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153023001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.