Lacie Pennington, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6501 Harris Pkwy
Fort Worth, TX 76132-6102

Phone

(817) 370-9891

NPI assigned

Aug 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Miss Lacie Webb Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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.

• Sportherapy LLC

  • Physical Therapy Clinic/Center
  • Fort Worth, TX
  • NPI 1386132132

  Physical Therapist

  Medicare reassignment NPD
• Sportherapy Southwest, PC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Fort Worth, TX
  • NPI 1801812698

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1013565530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326102",
            "telephone_number": "817-370-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326102",
            "telephone_number": "817-370-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "LACIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "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": "1323923",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1323923",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACIE",
            "last_name": "WEBB",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Makayla Marie Penner, MD
• Michael William Penney, MD
• Taylor Penning
• Emily M Penninger, PNP
• Mark Penninger, FNP
• Melissa Pennington, D.O.
• Nicole Amber Pennington
• Pennsylvania Rehab LP
• Richard E. Penny, M.D.
• Karen Ann Penrod, LPC

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.