PURPLE AMPHIBIAN, LLC (NPI# 1881850295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881850295 |
| Entity Type | Organization |
| Organization Name | PURPLE AMPHIBIAN, LLC |
| Practice Address |
7451 Chapel Ave Fort Worth TX 76116-7090 |
| Mailing Address |
Po Box 2626 Fort Worth TX 76113-2626 |
| Practice Telephone | 8179262544 |
| Mailing Telephone | 8172947444 |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2011-06-17 |
| Authorized Official Name | CECE J PANNELL (OFFICE MANAGER) |
| Authorized Official Telephone | 8172947444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
648218 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS TX | 0025KE | 01 |
| Street Address |
7451 CHAPEL AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76116-7090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962454587 | Joseph J Bowes IIi | Nurse Anesthetist, Certified Registered | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2006-05-16 |
| 1184146953 | Sheryl Mahony Rutledge | Registered Nurse | 7451 Chapel Ave, Fort Worth, TX 76116 | 2017-07-12 |
| 1619352945 | Sozo Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2015-07-28 |
| 1154705283 | Hollas Anesthesia | Nurse Anesthetist, Certified Registered | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2015-07-18 |
| 1366841587 | Roswell Procedural Medicine Associates | Nurse Anesthetist, Certified Registered | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2014-08-14 |
| 1396165908 | Heather Goforth | Nurse Anesthetist, Certified Registered | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2014-04-22 |
| 1144660150 | Tania Ramos | Specialist/Technologist, Other | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2013-07-05 |
| 1518211408 | Craig M Moore | Specialist/Technologist, Other | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2012-10-31 |
| 1366729147 | Guillermo Guardiola Pllc | Nurse Anesthetist, Certified Registered | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2011-11-08 |
| 1013150341 | Shelly R Smith Rnfa Surgical Assist Pllc | Registered Nurse | 7451 Chapel Ave, Fort Worth, TX 76116-7090 | 2009-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908980 | William Michael Marshall | Pharmacist | 8600 Camp Bowie Blvd, Forth Worth, TX 76116 | 2020-10-02 |
| 1558843599 | Donnisha Bunting | In Home Supportive Care | 2901 Broadmoor, 1115, Fort Worth, TX 76116 | 2018-09-06 |
| 1588156756 | Bilal Master | Student in an Organized Health Care Education/Training Program | 3309 Riveroad Court, 2515, Ft Worth, TX 76116 | 2018-06-04 |
| 1245769728 | Randall R Williams | Physical Therapist | 6913 Camp Bowie Blvd Suite 141, Fort Worth, TX 76116 | 2017-06-08 |
| 1023543048 | 5th Avenue Grooming Lounge | Prosthetic/Orthotic Supplier | 1201 N Watson Rd., Suite 283, Arlington, TX 76116 | 2017-04-27 |
| 1831647734 | Frisco Neuro Collaborations, Pllc | Physician Assistant | 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 | 2016-09-20 |
| 1104288372 | Brown Mobile Dental Pa | Dentist | 8008 Camp Bowie W Blvd, Ste 101, Fort Worth, TX 76116 | 2016-03-25 |
| 1639553431 | Bartholomew A Akubukwe | Pharmacist | 6700 Westfree Way, Fortworth, TX 76116 | 2015-07-13 |
| 1952718868 | Brown Mobile Dental | Dentist | 8008 Camp Bowie Suite 101, Fort Worth, TX 76116 | 2014-07-14 |
| 1275949018 | Emily Sue Danner | Dentist | 6726 Camp Bowie Blvd., Fort Worth, TX 76116 | 2014-07-01 |
| Find all providers in zip 76116 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447789896 | Texas Surgical Ally | Physician Assistant | 6677 Friendsway Dr, Fort Worth, TX 76137 | 2017-06-08 |
| 1831647734 | Frisco Neuro Collaborations, Pllc | Physician Assistant | 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 | 2016-09-20 |
| 1205299138 | Trasimeno, LLC | Physician Assistant | 9800 Sinclair St, Fort Worth, TX 76244-5890 | 2016-03-29 |
| 1770974727 | Melvin Johnson | Physician Assistant | 1016 Grand National Blvd, Fort Worth, TX 76179-2336 | 2015-02-12 |
| 1780924415 | Erica Valenzuela | Physician Assistant | 521 Darlington Trl, Fort Worth, TX 76131-3541 | 2013-02-16 |
| 1871746230 | Ansurio Cardona Jr. | Physician Assistant | 11800 Horseshoe Ridge Dr, Fort Worth, TX 76244-4892 | 2008-10-29 |
| 1548481781 | Henry Lee Collins | Physician Assistant | 2713 Clovermeadow Dr, Fort Worth, TX 76123-2107 | 2007-05-02 |
| 1376583906 | Stephanie Lynn Curtis | Physician Assistant | 800 5th Ave Ste 300, Fort Worth, TX 76104-7303 | 2006-06-08 |
| 1992774103 | Sarah Rodriguez | Physician Assistant | 3637 Bellaire Dr S, Fort Worth, TX 76109-2135 | 2006-03-17 |
| 1811597321 | Kathryn Varano | Physician Assistant | 1250 8th Ave, Fort Worth, TX 76104-4124 | 2020-10-26 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76116 |
Please comment or provide details below to improve the information on PURPLE AMPHIBIAN, LLC.
| 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.