Tan Ta

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3020 E Broad St Ste 112
Mansfield, TX 76063-6696

Phone

(682) 422-7580

NPI assigned

Jan 29, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1003678673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E BROAD ST STE 112",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636696",
            "telephone_number": "682-422-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 E BROAD ST STE 112",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636696",
            "telephone_number": "682-422-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "TAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophie Blaire Swain
• Joya K Sykes, DO
• Synergy Aquatic and Land Therapy LLC
• Magdalene Maria Szuszkiewicz-Garcia, MD
• T.O. Loving Care LLC
• Abel Nyakundi Tachiri
• Amy Christine Tackel, NP
• Shane M Tackitt, DO
• Jennifer Dawn Taggart, LPC
• James Anthony Tagle Jr., ACNP

• Physical Therapist in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.