COOK CHILDREN'S MEDICAL CENTER (NPI# 1821069709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821069709 |
| Entity Type | Organization |
| Organization Name | COOK CHILDREN'S MEDICAL CENTER |
| Other Organization Name | MOBILE ECHO |
| Practice Address |
801 7th Ave Fort Worth TX 76104-2733 |
| Mailing Address |
Po Box 99213 Fort Worth TX 76199-0213 |
| Practice Telephone | 6828854000 |
| Practice Fax Number | 6828851903 |
| Mailing Telephone | 6828854432 |
| Mailing Fax Number | 6828853936 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2015-06-26 |
| Authorized Official Name | STEPHEN W KIMMEL (VP OF FINANCE, CCMC) |
| Authorized Official Telephone | 6828857663 |
| Is Organization Subpart | Y |
| Parent Organization Name | COOK CHILDREN'S MEDICAL CENTER |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities | ||
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
000332 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 153012301 | 05 |
| Other Name | Type Code |
|---|---|
| MOBILE ECHO | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104383983 | Cook Children's Medical Center | Clinic/Center | 4300 W University Dr, Prosper, TX 75078-9806 | 2019-02-27 |
| 1326548280 | Cook Children's Medical Center | Pediatrics | 6316 Precinct Line Rd Ste A, Hurst, TX 76054-2766 | 2018-02-17 |
| 1942509963 | Cook Children's Medical Center | Psychologist | 901 7th Ave Ste 2100, Fort Worth, TX 76104-2722 | 2011-03-16 |
| 1215907530 | Cook Children's Medical Center | Ambulance | 124 Texas Way, Fort Worth, TX 76106-2773 | 2006-01-26 |
| 1760452080 | Cook Children's Medical Center | Clinic/Center | 1500 Cooper St Fl 1, Fort Worth, TX 76104-2710 | 2006-01-26 |
| 1316409105 | Cook Children's Medical Center | Clinic/Center | 13340 Highland Hills Dr, Aledo, TX 76008 | 2019-04-02 |
| 1609338490 | Cook Children's Medical Center | Pediatrics | 13340 Highland Hills Dr, Aledo, TX 76008 | 2019-04-02 |
| 1003373887 | Cook Children's Medical Center | Pediatrics | 4300 W University Dr, Prosper, TX 75078-9806 | 2019-02-27 |
| 1114427911 | Cook Children's Medical Center | Clinic/Center | 6316 Precinct Line Rd Ste A, Hurst, TX 76054-2766 | 2018-02-19 |
| 1538669916 | Cook Children's Medical Center | Pediatrics | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2018-02-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COOK CHILDREN'S MEDICAL CENTER | 801 7th Ave, Fort Worth, TX 76104-2733 |
| Street Address |
801 7TH AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-2733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315010 | Jon Michael Badgwell | Anesthesiology | 801 7th Ave, Fort Worth, TX 76104-2733 | 2005-06-08 |
| 1609482884 | Tiffani Christensen | Nurse Practitioner | 801 7th Ave, Fort Worth, TX 76104-2796 | 2020-09-22 |
| 1528676723 | Kaitlin Renee Noyes | Pediatrics | 801 7th Ave, Fort Worth, TX 76104-2733 | 2020-07-14 |
| 1114567369 | Lauren Elizabeth Walker | Nurse Practitioner | 801 7th Ave, Fort Worth, TX 76104-2733 | 2020-01-15 |
| 1124667753 | Kirsten A Gomez | Social Worker | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-12-30 |
| 1841838448 | Mark Cole Carrillo | Nurse Anesthetist, Certified Registered | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-12-13 |
| 1326686148 | Erica Burton | Nurse Anesthetist, Certified Registered | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-12-11 |
| 1689217432 | Claire Koskie | Dietitian, Registered | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-10-24 |
| 1437709243 | Rhonda Maritza Andi | Nurse Practitioner | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-09-13 |
| 1972061034 | Katharine Avery Molloy | Nurse Anesthetist, Certified Registered | 801 7th Ave, Fort Worth, TX 76104-2733 | 2019-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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|---|---|---|---|---|
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| 1285087775 | Health 2 Go | Clinic/Center | 4229 Bridgestone Dr, Fort Worth, TX 76123-8006 | 2016-07-20 |
| 1104218619 | Dr. Ankit Patel P.a. | Clinic/Center | 3825 E Belknap St, Fort Worth, TX 76111-6020 | 2015-02-21 |
| 1871985499 | Beyond The Veil | Clinic/Center | 7724 Marble Canyon Dr, Fort Worth, TX 76137-4156 | 2015-02-19 |
| 1750785705 | Legacy Neurology & Sleep of North Texas | Clinic/Center | 10369 Bradshaw Dr, Fort Worth, TX 76108-6990 | 2014-10-20 |
| 1295157030 | Beaty Business Spendthrift Trust | Clinic/Center | 1605 Clover Ln, Fort Worth, TX 76107-3902 | 2014-01-14 |
| 1093050940 | Fyatt Healthcare | Clinic/Center | 1608 Windsong Trl, 615, Fort Worth, TX 76120-4223 | 2012-12-04 |
| 1629227673 | Concentra Health Services, Inc. | Clinic/Center | 2500 West Fwy., Suite 100, Fort Worth, TX 76102-5848 | 2008-09-15 |
| 1649457896 | Channing Enterprise Inc | Clinic/Center | 1009 Baker St, Fort Worth, TX 76104-7211 | 2008-01-29 |
| 1528259322 | Md Pain Clinic, Inc. | Clinic/Center | 2406 W Seminary Dr, Fort Worth, TX 76115-1917 | 2007-08-06 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on COOK CHILDREN'S MEDICAL CENTER.
| 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.