COOK CHILDREN'S PHYSICIAN NETWORK (NPI# 1548230923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548230923 |
| Entity Type | Organization |
| Organization Name | COOK CHILDREN'S PHYSICIAN NETWORK |
| Other Organization Name | COOK CHILDREN'S DEVELOPMENTAL PEDIATRICS |
| Practice Address |
1300 W Lancaster Ave Fort Worth TX 76102 |
| Mailing Address |
Po Box 733784 Dallas TX 75373-3784 |
| Practice Telephone | 8173368111 |
| Practice Fax Number | 8173362823 |
| Mailing Telephone | 6828856163 |
| Mailing Fax Number | 6828857337 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | WILLIAM B NELSON (PRESIDENT, CCPN) |
| Authorized Official Telephone | 6828857549 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | COOK CHILDREN'S PHYSICIAN NETWORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| COOK CHILDREN'S DEVELOPMENTAL PEDIATRICS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255882411 | Cook Children's Physician Network | Clinic/Center | 801 7th Ave, Fort Worth, TX 76104-2733 | 2016-10-21 |
| 1467903088 | Cook Children's Physician Network | Pediatrics | 801 7th Ave, Fort Worth, TX 76104-2733 | 2016-10-19 |
| 1235276130 | Cook Children's Physician Network | Emergency Medicine | 801 7th Ave, Fort Worth, TX 76104-2733 | 2007-01-31 |
| 1669442042 | Cook Children's Physician Network | Pediatrics | 801 7th Ave, Fort Worth, TX 76104-2733 | 2006-01-26 |
| 1750369203 | Cook Children's Physician Network | Pediatrics | 801 7th Ave, Fort Worth, TX 76104-2733 | 2006-01-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COOK CHILDREN'S PHYSICIAN NETWORK | 801 7th Ave, Fort Worth, TX 76104-2733 |
| Street Address |
1300 W LANCASTER AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841281318 | Lesley M Drummond-borg | Medical Genetics | 1300 W Lancaster Ave, Ste 204, Fort Worth, TX 76102-3410 | 2005-11-02 |
| 1619508330 | Melinda Robison | Behavioral Analyst | 1300 W Lancaster Ave, Fort Worth, TX 76102-3499 | 2020-01-31 |
| 1710421474 | Kathryn Fruit | Dietitian, Registered | 1300 W Lancaster Ave, Ste 204, Fort Worth, TX 76102-3410 | 2016-12-14 |
| 1205219961 | Joshua Jessel | Behavioral Analyst | 1300 W Lancaster Ave, Fort Worth, TX 76102-3410 | 2015-06-30 |
| 1053729525 | Katherine Schaars | Audiologist | 1300 W Lancaster Ave, Ste 106, Fort Worth, TX 76102-3410 | 2014-07-29 |
| 1720420722 | Jayme Stiller | Nurse Practitioner | 1300 W Lancaster Ave, Fort Worth, TX 76102-3410 | 2013-07-19 |
| 1922354166 | Candace Nicole Gamble | Medical Genetics | 1300 W Lancaster Ave, Ste 204, Fort Worth, TX 76102-3410 | 2012-07-25 |
| 1710246343 | Carla Michelle Smith | Behavioral Analyst | 1300 W Lancaster Ave, Fort Worth, TX 76102-3410 | 2012-05-16 |
| 1962709410 | Einar Ingvarsson | Behavioral Analyst | 1300 W Lancaster Ave, Fort Worth, TX 76102-3410 | 2011-02-18 |
| 1275838088 | Tina Grace Barbaro Dieber | Medical Genetics | 1300 W Lancaster Ave, Ste 204, Fort Worth, TX 76102-3410 | 2011-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285113746 | Deirdre P Browne | Counselor | 1500 E El Paso, Fort Worth, TX 76102 | 2018-08-07 |
| 1740784206 | Cvs Pharmacy Inc | Pharmacy | 515 Houston St, Fort Worth, TX 76102 | 2018-03-20 |
| 1316448061 | Diondra Deshawn Narcisse | Licensed Vocational Nurse | 1314 Lake Street, Fort Worth, TX 76102 | 2018-02-27 |
| 1649779943 | Carmela A Solis | Specialist/Technologist, Other | 500 Throckmorton Street Unit 3309, Fort Worth, TX 76102 | 2018-02-02 |
| 1104324516 | Vicki Webb-baker | Health Educator | 512 Lamar Street, Suite 400, Fort Worth, TX 76102 | 2018-01-31 |
| 1235647678 | Brianna Marie Keister | Occupational Therapist | 201 W. Lancaster Ave, 417, Fort Worth, TX 76102 | 2018-01-19 |
| 1437507910 | Medical Hearing Services, LLC | Hearing Aid Equipment | 1201 Summit Avenue, Fort Worth, TX 76102 | 2016-05-25 |
| 1891171476 | Karis Starke | Physical Therapy Assistant | 2500 West Freeway (i-30), 100, Fort Worth, TX 76102 | 2015-08-05 |
| 1265839344 | Fm Katy Dental and Orthodontics, Pllc | Dentist | 100 E 15th Ste 520, Fort Worth, TX 76102 | 2014-12-04 |
| 1093134512 | Superior Evaluation Services | General Practice | 420 Throckmorton Suite 200, Ft. Worth, TX 76102 | 2014-04-11 |
| Find all providers in zip 76102 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760710636 | Saletha Brenetha Smith | Pediatrics | 1300 W Lancaster Ave Ste 205, Fort Worth, TX 76102-3490 | 2009-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932615234 | Pediatrics Plus Therapy | Pediatrics | 6025 Sports Village Road, Frisco, TX 75033 | 2017-12-21 |
| 1508371824 | Kamvic Home Health Care LLC | Pediatrics | 21111 Barton Hollow Ln, Richmond, TX 77407-6416 | 2017-12-08 |
| 1962838458 | Sheri Michelle Ravenscroft | Pediatrics | 5359 N Ih 35 Frontage Rd, Ste 100, Austin, TX 78723-6300 | 2013-09-17 |
| 1467650564 | Charles Mike Rios | Pediatrics | 1100 S. Main St. #103, Grapevine, TX 76051 | 2007-07-10 |
| 1891908901 | Harold Mark Welch Jr. | Pediatrics | 3019 Medlin Dr, Suite 100, Arlington, TX 76015-2307 | 2007-05-07 |
| 1699987651 | Peter Campbell Ray | Pediatrics | 8300 Douglas Ave Ste 731, Dallas, TX 75225-5825 | 2007-05-03 |
| 1447384706 | Julie Jacob | Pediatrics | 8501 Wade Blvd Ste 330, Frisco, TX 75034-6264 | 2007-03-16 |
| 1134285430 | Jeri L Penkava | Pediatrics | 1370 Pantheon Way Ste 250, San Antonio, TX 78232-2290 | 2006-12-29 |
| 1598873135 | Beatrice Thetgyi Ting | Pediatrics | 3607 Rivera Ave, El Paso, TX 79905-2415 | 2006-08-25 |
| 1699718205 | Heidi A Castillo | Pediatrics | 6701 Fannin Street, Suite 1530, Houston, TX 77030 | 2006-06-13 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76102 |
Please comment or provide details below to improve the information on COOK CHILDREN'S PHYSICIAN NETWORK.
| 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.