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FOSSIL CREEK FAMILY MEDICAL CENTER
NPI 1639267982
Family Medicine in Fort Worth, TX

Active since October 11, 2006CLIA 45D0686536 · Microscopy
7510 N BEACH ST, FORT WORTH, TX 76137(817) 498-1818(817) 581-3761 Get Directions Write a Review

NPPES record last updated: March 15, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 15, 2019, Jul 31, 2018 (2 updates tracked since 2018).

About Fossil Creek Family Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOSSIL CREEK FAMILY MEDICAL CENTER (NPI 1639267982) is a healthcare organization registered as a family medicine in Fort Worth, Texas and active in the NPI registry since October 2006. The organization holds a CLIA Microscopy certificate valid through July 6, 2027 and lists David Wayne Simonak, Owner, as its authorized official.

NPPES Registry Identity

NPI1639267982
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFOSSIL CREEK FAMILY MEDICAL CENTER
Location Address7510 N BEACH STFort Worth, TX 76137
Mailing Address7500 N Beach StFort Worth, TX 76137-1505 · (817) 498-1818 · Fax (817) 581-3761
Phone(817) 498-1818
Fax(817) 581-3761
Organization SubpartNo
Authorized OfficialDavid Wayne SimonakOwner · (817) 498-1818
Enumeration DateOctober 11, 2006
Last NPPES UpdateMarch 15, 20192 updates tracked since enumeration
✔ NPI 1639267982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
7510 N BEACH ST, Fort Worth, TX 76137
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Other Identifiers 1

Medicaid121142701TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0686536

Fossil Creek Family Medical Center · Fort Worth, TX
Active · expires Jul 6, 2027
CLIA Number45D0686536
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorDavid W. Simonak
Laboratory Phone(817) 498-1818
Laboratory LocationFossil Creek Family Medical Center7510 North Beach Street, Fort Worth, TX 76137
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KRISTA NICOLE WATKINS PA
Physician Assistant
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (817) 498-1818
CASIE LAINE COON FNP
Nurse Practitioner (Family)
7510 N BEACH ST
FT WORTH, TX 76137
Tarrant County (817) 498-1818
HANNAH KAYE PAYTON PA-C
Physician Assistant
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (817) 498-1818
STEPHANIE HELIOT EDWARDS PA-C
Physician Assistant
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (817) 498-1818
MRS. VALERIE JONES PA-C
Physician Assistant
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (817) 498-1818
PAUL INHO CHO PA-C
Physician Assistant
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (817) 498-1818
MADELINE SMITH MSN, APRN, FNP-C
Nurse Practitioner
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (936) 419-9621
DR. BRADY PUTNAM SIMONAK D.O.
Family Medicine
7510 N BEACH ST
FORT WORTH, TX 76137
Tarrant County (817) 498-1818

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fossil Creek Family Medical Center's NPI number?

The NPI number for Fossil Creek Family Medical Center is 1639267982. It was assigned to this organization in the NPPES registry on October 11, 2006.

Where is Fossil Creek Family Medical Center located?

Fossil Creek Family Medical Center is located at 7510 N Beach St, Fort Worth, TX 76137. The listed phone number is (817) 498-1818.

What is Fossil Creek Family Medical Center's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Fossil Creek Family Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D0686536) is associated with this NPI, valid through July 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fossil Creek Family Medical Center accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Fossil Creek Family Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fossil Creek Family Medical Center was last updated on March 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.