Active NPI
Emcc Chisholm Trail, LLC
- Emergency Medicine Physician
- Fort Worth, TX
National Provider Identifier
1992273544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- EMCC CHISHOLM TRAIL, LLC
- Practice address
- 7445 Oakmont Blvd
Fort Worth, TX 76132-3905 - Phone
- (469) 830-8200
- NPI assigned
- Nov 12, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Newsom
- Title
- President
- Phone
- (469) 830-8200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
7445 Oakmont Blvd
Fort Worth, TX 76132-3905
Mailing address
2300 Matlock Rd Ste 35
Mansfield, TX 76063-5018
Phone (469) 830-8200
Other names 1
- Surepoint Emergency Center Chisholm Trail
National Provider Directory
National Provider DirectoryLocations
960 Ridgeview Dr
Ste 140122
Allen, TX 75013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727395200000",
"number": "1992273544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 MATLOCK RD STE 35",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760635018",
"telephone_number": "469-830-8200",
"fax_number": "469-830-8201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7445 OAKMONT BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761323905",
"telephone_number": "469-830-8200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMCC CHISHOLM TRAIL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-12",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A",
"authorized_official_last_name": "NEWSOM",
"authorized_official_first_name": "MICHELLE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "469-830-8200"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Surepoint Emergency Center Chisholm Trail",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.