Individual provider Active NPI

Gaius B Fomuso

  • Case Manager/Care Coordinator
  • Mansfield, TX
National Provider Identifier
1982957106
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
203 Lorient Dr
Mansfield, TX 76063-5572
Phone
(214) 256-6648
NPI assigned
Oct 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X Primary

Addresses

Primary practice location

203 Lorient Dr
Mansfield, TX 76063-5572

Mailing address

203 Lorient Dr
Mansfield, TX 76063-5572
Phone (214) 256-6648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1982957106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 LORIENT DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635572",
            "telephone_number": "214-256-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 LORIENT DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635572",
            "telephone_number": "214-256-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMUSO",
        "first_name": "GAIUS",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.