Robert Mark Blackburn, PT
Individual provider Active NPI Physical Therapist · Stephenville, TX
NPI 1003980871 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003980871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1123263 (TX)
- Practice address
- Stephenville Sports Rehab and Physical Therapy Inc
2269 NW Loop
Stephenville, TX 76401 - Phone
- (254) 965-2723
- Fax
- (254) 965-7394
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hometown Physical Therapy LLC
Practice addresses (Care Compare)
2269 Sen Robert J Glasgow Loop
Stephenville, TX 76401-1701
Phone (254) 965-2040
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220218000874 | TX | Practitioner - Physical Therapist in Private Practice | 4385553320 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Hometown Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Weatherford Physical Therapy Inc | Physical Therapist | Past |
Accepting new patients |
Locations
712 N Second St
Ste A
Hico, TX 76457
Phone (254) 796-2150
2269 Senator Robert J Glasgow Loop
Stephenville, TX 76401
Phone (254) 965-2040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1123263 | TX | Yes |
Addresses
Primary practice location
Stephenville Sports Rehab and Physical Therapy Inc
2269 NW Loop
Stephenville, TX 76401
Mailing address
2269 N W Loop
Stephenville, TX 76401
Phone (254) 965-2723
Other providers in Stephenville, TX
- Bridgette Bednarz
- Caitlyn Benson
- Donald E Benson
- Jeffrey Bierman
- Allyson Black
- Blakeley Enterprise Inc.
- Melissa Lynne Blue
- Izaiah Bogs
- Hayley Booker
- David Boucher
All providers in Stephenville, TX · Physical Therapist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.