Active NPI
Sourachack Steve Sananikone, DPT
- Physical Therapist
- Houston, TX
National Provider Identifier
1013225002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1200953
- Practice address
- 5151 Katy Fwy
Suite 305
Houston, TX 77007-2260 - Phone
- (713) 562-1031
- NPI assigned
- Sep 23, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1200953 | TX | Primary |
Addresses
Primary practice location
5151 Katy Fwy
Suite 305
Houston, TX 77007-2260
Mailing address
13202 Briar Forest Dr
Apt. # 1108
Houston, TX 77077-2434
Phone (443) 235-6410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
209 S a St
Pensacola, FL 32502-5554
Phone (850) 533-0266
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1200953 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolve Therapy and Wellness PLLC | Physical Therapist | Current | Accepting new patients |
| Iperformance Center | Physical Therapist | Current | Accepting new patients |
Locations
209 S A St
Pensacola, FL 32502
Phone (850) 533-0266
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.
-
- Physical Therapist
- Pensacola, FL
- NPI 1932815644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1013225002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13202 BRIAR FOREST DR",
"address_2": "APT. # 1108",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770772434",
"telephone_number": "443-235-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5151 KATY FWY",
"address_2": "SUITE 305",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770072260",
"telephone_number": "713-562-1031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANANIKONE",
"first_name": "SOURACHACK",
"middle_name": "STEVE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-23",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1200953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.