Organization Active NPI

Merritt Mobile Therapy, PLLC

  • Physical Therapist
  • Lindale, TX
National Provider Identifier
1023701471
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MERRITT MOBILE THERAPY, PLLC
Practice address
15843 County Road 4191
Lindale, TX 75771-7768
Phone
(903) 492-5215
NPI assigned
May 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Logan Merritt, PTNPI 1376022129
Title
Managing Member/Owner
Phone
(903) 492-5215

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

15843 County Road 4191
Lindale, TX 75771-7768

Mailing address

15843 County Road 4191
Lindale, TX 75771-7768
Phone (903) 492-5215

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230629004239 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7517326184 Receives reassigned benefits from 5 practitioners
Practice locations: Lindale, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1023701471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15843 COUNTY ROAD 4191",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757717768",
            "telephone_number": "903-492-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15843 COUNTY ROAD 4191",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757717768",
            "telephone_number": "903-492-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRITT MOBILE THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "903-492-5215",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindale, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.