JIM K MARUTHOOR (NPI# 1437378247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437378247 |
| Entity Type | Individual |
| Full Name | JIM K MARUTHOOR |
| Credential | MD |
| Practice Address |
855 Montgomery Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8177352000 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 01084153A | IN | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | N8541 | TX | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | MT185083 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE OF IL | 036119796 | 01 |
| TX | BCBS | 8CW349 | 01 |
| WI | STATE OF WI | 505950202 | 01 |
| PA | LICENSE | MT185083 | 01 |
| Street Address |
855 MONTGOMERY |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194711747 | Victor Lamont Holmes | Physician Assistant | 855 Montgomery, Fort Worth, TX 76107-2553 | 2005-09-20 |
| 1093117848 | Keely Nicole Grant Mirle | Nurse Practitioner | 855 Montgomery, Fort Worth, TX 76107-2553 | 2014-09-24 |
| 1750722187 | Felicia Ann Hoffman | Physician Assistant | 855 Montgomery, Fort Worth, TX 76107-2553 | 2013-07-15 |
| 1194075101 | Christie Peer Shanafelt | Neuromusculoskeletal Medicine & OMM | 855 Montgomery, Fort Worth, TX 76107-2553 | 2012-09-17 |
| 1760737142 | Tomi Omolara Ola-peters | Internal Medicine | 855 Montgomery, Fort Worth, TX 76107-2553 | 2012-07-20 |
| 1386930709 | Crystal Diane Walker | Physician Assistant | 855 Montgomery, Fort Worth, TX 76107-2553 | 2011-06-23 |
| 1881908598 | America E Mcguffee | Physician Assistant | 855 Montgomery, Fort Worth, TX 76107-2553 | 2010-08-05 |
| 1144534173 | James Raymond Leddy | Physician Assistant | 855 Montgomery, Fort Worth, TX 76107-2553 | 2010-08-02 |
| 1548401094 | Yue-qing Tan | Internal Medicine | 855 Montgomery, Fort Worth, TX 76107-2553 | 2009-03-13 |
| 1386892966 | Anjali Kumar | Family Medicine | 855 Montgomery, Fort Worth, TX 76107-2553 | 2008-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023581006 | Leon S Tio Md Pa | Internal Medicine | 800 8th Ave Ste 336, Fort Worth, TX 76104-2614 | 2019-01-02 |
| 1174009385 | Universal Clinical Care LLC. | Internal Medicine | 2502 Via Nicola Apt 3424, Fort Worth, TX 76109-5587 | 2018-07-11 |
| 1417458068 | Fort Worth Primary Care, Pllc | Internal Medicine | 800 8th Ave Ste 626, Fort Worth, TX 76104-2605 | 2018-02-27 |
| 1750753976 | Momentum Health Partners Pllc | Internal Medicine | 4551 Boat Club Rd, Fort Worth, TX 76135-2004 | 2015-10-27 |
| 1013399286 | Aman Kanti Patel | Internal Medicine | 2502 Via Nicola, Apt # 3424, Fort Worth, TX 76109-6566 | 2015-06-24 |
| 1053705855 | Deidi Ann Bergestuen | Internal Medicine | 5450 Clearfork Main Street Suite 300, Fort Worth, TX 76109-7208 | 2015-03-19 |
| 1992198188 | Jack Ni | Internal Medicine | Baylor Scott & White All Saints Medical Center, 1400 8th Ave, Fort Worth, TX 76104-4192 | 2015-03-11 |
| 1184054066 | Dfw Premier Healthcare Pa | Internal Medicine | 4844 Sangers Ct, Fort Worth, TX 76244-9119 | 2013-11-14 |
| 1588094593 | T Off Men's Health | Internal Medicine | 601 Penn St, Fort Worth, TX 76102-2619 | 2013-11-13 |
| 1174957054 | Medhealth Center Inc | Internal Medicine | 112 Nw 24th St Ste 206, Fort Worth, TX 76164-8577 | 2013-08-27 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.