Individual provider Active NPI

Jordan Rogers, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1013500537
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4108 Boat Club Rd
Fort Worth, TX 76135-2604
Phone
(817) 238-9295
NPI assigned
Feb 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4108 Boat Club Rd
Fort Worth, TX 76135-2604

Mailing address

4108 Boat Club Rd
Fort Worth, TX 76135-2604
Phone (817) 238-9295

Other identifiers 1

IdentifierTypeStateIssuer
1342501OtherTXPT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportherapy LLC Physical Therapist CurrentSince Feb 3, 2021 Accepting new patients
Sportherapy Southwest, PC Physical Therapist PastSince Feb 3, 2021 Accepting new patients

Locations

4108 Boat Club Rd
Lake Worth, TX 76135
Phone (817) 238-9295

965 Hilltop Dr
Weatherford, TX 76086
Phone (817) 370-9891

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": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1013500537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352604",
            "telephone_number": "817-238-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761352604",
            "telephone_number": "817-238-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "JORDAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1342501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.