Jordan L Holcombe, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA08329 Issued in TX

Practice address

6301 Harris Pkwy Ste 300
Fort Worth, TX 76132-4245

Phone

(817) 877-3432

Fax

(817) 346-4394

NPI assigned

Jan 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jordan L Wackenhuth Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Legacy Heart Care of Fort Worth, LLC

  • Cardiovascular Disease Physician
  • Fort Worth, TX
  • NPI 1730120908

  TX

  Medicare reassignment
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596

  TX

  Medicare reassignment
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1992042923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 HARRIS PKWY STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324245",
            "telephone_number": "817-877-3432",
            "fax_number": "817-346-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 HARRIS PKWY STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324245",
            "telephone_number": "817-877-3432",
            "fax_number": "817-346-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMBE",
        "first_name": "JORDAN",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-10",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA08329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323432001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "WACKENHUTH",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Holbeck
• Courtney Brosang Holbrook, LPC
• Christina Grey Holbrooks
• Aubrey Holcomb
• Robert A Holcomb, M.D.
• Crystal Renee Holden, FNP
• Haley Holden, CCC-SLP
• Jill Kay Holden, OTR
• Lindsey Holder
• Stephanie Holder, FNP

• All providers in Fort Worth, TX
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.