Individual provider Active NPI

Nkemakolem Nwosu

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1003972092
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1201719 Issued in TX
Practice address
9291 Garland Rd Ste 110
Dallas, TX 75218-2850
Phone
(972) 892-4541
Fax
(469) 697-1094
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1201719
Physical Therapist 225100000X 1201719 TX Primary

Addresses

Primary practice location

9291 Garland Rd Ste 110
Dallas, TX 75218-2850

Mailing address

790 Remington Blvd Apt 106
Bolingbrook, IL 60440-4909

Other practice location 1

316 Washington Ave
apt. 106
Wheeling, WV 26003-6243
Phone (617) 230-1890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191116000101 TX Practitioner - Physical Therapist in Private Practice 1951733757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

790 Remington Blvd
Apt 106
Bolingbrook, IL 60440

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

9291 Garland Rd
Ste 110
Dallas, TX 75218
Phone (972) 892-4541

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1003972092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD APT 106",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9291 GARLAND RD STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182850",
            "telephone_number": "972-892-4541",
            "fax_number": "469-697-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 Washington Ave",
            "address_2": "apt. 106",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "WV",
            "postal_code": "260036243",
            "country_code": "US",
            "telephone_number": "617-230-1890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWOSU",
        "first_name": "NKEMAKOLEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "1201719",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1201719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.