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Jamie Arthur Nivens

Family Medicine

Allopathic & Osteopathic Physicians

600 S Main St, Fort Worth, TX 76104-2410

PECOS Enrollment

This provider is enrolled in PECOS as JAMIE NIVENS.

Based on the most recent information from CMS, provider Jamie Arthur Nivens is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1215983572
Provider Type
Individual
Full Name
Nivens, Jamie Arthur
Title
Dr.
Credential
D.O.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
5/26/2006
Last Updated
3/3/2022

Contact Information

Practice Location

600 S Main St, Fort Worth, TX 76104-2410

(214) 648-8388

Unlisted Fax

Mailing Location

5323 Harry Hines Blvd Ste 1650, Dallas, TX 75390-7208

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License H4578 Texas

Provider Identifiers

ID	Description	Issuer
ID 87811F	Description Other	Issuer BCBS Texas
ID 080189794	Description Other	Issuer RR MEDICARE Texas
ID 121006402	Description Medicaid	Issuer Unlisted Texas

Jamie Arthur Nivens

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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Grant, Karen M

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Hoang, Anh Thi

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Tran, Kim Thuy

Criswell, Jared