CCRM DFW, LLC (NPI# 1437636636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437636636 |
| Entity Type | Organization |
| Organization Name | CCRM DFW, LLC |
| Other Organization Name | CCRM DALLAS FORT WORTH |
| Practice Address |
8380 Warren Pkwy Ste 201 Frisco TX 75034 |
| Mailing Address |
9380 Station St Ste 425 Lone Tree CO 80124-6832 |
| Practice Telephone | 9723772625 |
| Mailing Telephone | 3039681950 |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-25 |
| Authorized Official Name | JON PARDEW (CEO) |
| Authorized Official Telephone | 3039681950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLIA | 45D1095599 | 01 | |
| ASC LICENSE | 130394 | 01 |
| Other Name | Type Code |
|---|---|
| CCRM Dallas Fort Worth | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023642220 | Ccrm Dfw, LLC | Clinical Medical Laboratory | 8380 Warren Pkwy Ste 201, Frisco, TX 75034-4199 | 2020-02-26 |
| Street Address |
8380 WARREN PKWY STE 201 |
| City | FRISCO |
| State | TX |
| Zip Code | 75034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316231566 | Yetunde O Ibrahim | Obstetrics & Gynecology | 8380 Warren Pkwy Ste 201, Frisco, TX 75034 | 2011-06-06 |
| 1023642220 | Ccrm Dfw, LLC | Clinical Medical Laboratory | 8380 Warren Pkwy Ste 201, Frisco, TX 75034-4199 | 2020-02-26 |
| 1578049052 | Conceptive Care | Clinic/Center | 8380 Warren Pkwy Ste 201, Frisco, TX 75034-4199 | 2018-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275463 | Chiroconcepts of Frisco North Pllc | Chiropractor | 13108 Dallas Pkwy, Suite 410, Frisco, TX 75034 | 2020-11-06 |
| 1790394625 | Lindsey Wertheim | Nurse Practitioner | 4325 Preston Rd, #300, Frisco, TX 75034 | 2020-07-27 |
| 1154948198 | Walker Plastic Surgery Pllc | Surgery | 12590 Dallas Pkwy, Ste 200, Frisco, TX 75034 | 2020-06-25 |
| 1700425055 | Goldfish Group Inc. | Clinic/Center | 6735 Salt Cedar Way, Building 1, 1039-300, Frisco, TX 75034 | 2020-01-04 |
| 1255979506 | Livelife LLC | Clinic/Center | 8668 John Hickman Parkway, Frisco, TX 75034 | 2019-12-17 |
| 1215581780 | Magnolia Pediatrics | Pediatrics | 2875 Main St. Suite 104, Frisco, TX 75034 | 2019-08-01 |
| 1811555386 | Alexis Deann Rickey | Speech-Language Pathologist | 4300 Cotton Gin Road, Frisco, TX 75034 | 2019-05-30 |
| 1316500952 | Jtma Inc | Pharmacy | 5899 Preston Road, Bldg 6 Ste 602, Frisco, TX 75034 | 2019-04-18 |
| 1194388173 | Amplify Chiropractic, Pllc | Chiropractor | 8250 Gaylord Pkwy, Ste. 3, Room 21, Frisco, TX 75034 | 2019-04-16 |
| 1740742030 | Princy Kurian | Occupational Therapist | Baylor Scott & White Institute for Rehabilitation Dn, Frisco, TX 75034 | 2019-04-04 |
| Find all providers in zip 75034 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107454 | Frisco Asc LLC | Clinic/Center | 5616 Warren Pkwy Ste 100, Frisco, TX 75034-4165 | 2019-11-04 |
| 1053835983 | Group Surgical Partners Integrated LLC | Clinic/Center | 8350 Dallas Parkway Suite 100, Frisco, TX 75034 | 2017-08-02 |
| 1649793613 | Baylor Surgicare At Blue Star, LLC | Clinic/Center | 3800 Gaylord Parkway, Suite 410, Frisco, TX 75034 | 2017-07-21 |
| 1306255013 | Metamorpheon | Clinic/Center | 8350 Dallas Parkway, Suite 100, Frisco, TX 75034 | 2014-08-06 |
| 1699806018 | Legacy Surgery Center of Frisco Lp | Clinic/Center | 5616 Warren Parkway, Suite 100 & 100a, Frisco, TX 75034 | 2007-03-08 |
| 1609876556 | Peak One Surgery Center, LLC | Clinic/Center | 350 Peak One Drive, Frisco, CO 80443 | 2005-07-21 |
| 1225574098 | Stonebriar Surgery Center, LLC | Clinic/Center | 8380 Warren Pkwy, Ste 201, Frisco, TX 75034-4198 | 2017-01-17 |
| 1083038186 | Frisco Ambulatory Surgery Center, LLC | Clinic/Center | 5616 Warren Pkwy, 100, Frisco, TX 75034-4166 | 2014-02-10 |
| 1871924027 | Preston Surgery Center, LLC | Clinic/Center | 7589 Preston Rd, Suite 100, Frisco, TX 75034-5667 | 2013-12-12 |
| 1396023172 | Starwood Surgery Inc. | Clinic/Center | 6898 Lebanon Rd, Suite 102, Frisco, TX 75034-7473 | 2011-07-28 |
| Find all providers in FRISCO | ||||
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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.