Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellisa Krumm, MD

Individual provider Family Medicine Physician · NPI 1124105457

Ellisa Krumm, MD is a Family Medicine Physician in Fort Worth, Texas. Licensed in South Carolina, Tennessee and Texas. Registered with an NPI since 2006.

Licensed in
SC, TN, TX
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-1204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence Q2699 (TX)
Family Medicine Physician Taxonomy 207Q00000X · Licence 45018 (TN)
Family Medicine Physician Taxonomy 207Q00000X · Licence LL28867 (SC)

Record details

NPI number1124105457
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 1, 2006
Last updated in NPPESJune 6, 2017
Mailing address1500 S Main St, Fort Worth, TX 76104-4917

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