FMC MEDICAL FOUNDATION, INC. – Family Medicine Physician, NPI 1104255272
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for FMC MEDICAL FOUNDATION, INC.
1616 S KENTUCKY ST
BUILDING B, SUITE 100
AMARILLO, TX 791022252
Phone:
Type: Mailing
1500 S Coulter St Ste 3
Amarillo, TX 791061787
Phone: (806) 350-7601
Fax: (806) 350-7602
Type: Location
6 Medical Dr
Amarillo, TX 791064136
Phone: (806) 718-5130
Fax: (806) 718-5131
Type: Location
7306 SW 34th Ave Ste 3
Amarillo, TX 791211446
Phone: (806) 350-3010
Fax: (806) 350-3015
Type: Location
1500 S Coulter St Ste 1
Amarillo, TX 791061787
Phone: (806) 354-0404
Fax: (806) 358-4851
Type: Location
1500 S Coulter St Ste 6
Amarillo, TX 791061790
Phone: (806) 467-9777
Fax: (806) 467-9799
Type: Location
2329 Ross Osage
Amarillo, TX 79103
Phone: (806) 350-5790
Fax: (806) 350-5791
Type: Location
400 SW 14th Ave Ste 100
Amarillo, TX 791014140
Phone: (806) 337-4555
Fax: (806) 337-4551
Type: Location
911 23rd St
Canyon, TX 790154645
Phone: (806) 655-2104
Fax: (806) 655-0522
Type: Location
8601 Hillside Rd
Amarillo, TX 791198032
Phone: (806) 350-7280
Fax: (806) 350-7281
Type: Location
2501 Lakeview Dr
Amarillo, TX 791091531
Phone: (806) 358-9400
Fax: (806) 355-7864
Type: Location
7306 SW 34th Ave Ste 4
Amarillo, TX 791211446
Phone: (806) 350-8850
Fax: (806) 350-8855
Type: Location
5512 Gem Lake Rd Ste 500
Amarillo, TX 791064227
Phone: (806) 718-5130
Fax: (806) 718-5130
Type: Location
2701 S GEORGIA ST
AMARILLO, TX 791091979
Phone: (806) 350-3000
Fax: (806) 350-3337
Type: Location
2501 LAKEVIEW DR
AMARILLO, TX 791091531
Phone: (806) 358-9400
Fax: (806) 355-2453
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-11-14
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20141114001090 | O | Clinic/Group Practice | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 79102)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.