Individual provider Active NPI

William M Herritage II, PT

  • Physical Therapist
  • Lewisville, TX
National Provider Identifier
1033490677
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1207022 Issued in TX
Practice address
724 W Main
Ste 180
Lewisville, TX 75067
Phone
(972) 434-6024
Fax
(972) 434-2784
NPI assigned
Sep 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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 1207022 TX Primary

Addresses

Primary practice location

724 W Main
Ste 180
Lewisville, TX 75067

Mailing address

2670 Firewheel Dr.
Ste B
Flower Mound, TX 75028
Phone (972) 355-8301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230330000536 TX Practitioner - Physical Therapist in Private Practice 6103187612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longview Family Physical Therapy, LLCGroup PAC ID 6608264494, 3 clinicians

Practice addresses (Care Compare)

109 W Hoyt Dr
Longview, TX 75601-3614
Phone (430) 201-5645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1207022TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Longview Family Physical Therapy LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients

Locations

2001 Judson Rd
Ste 101
Longview, TX 75605
Phone (903) 309-0383

109 W Hoyt Dr
Longview, TX 75601
Phone (430) 201-5645

2001 Judson Rd
Longview, TX 75605

Organizations & group practices 1

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": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1033490677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 FIREWHEEL DR.",
            "address_2": "STE B",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "75028",
            "telephone_number": "972-355-8301",
            "fax_number": "972-355-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 W MAIN",
            "address_2": "STE 180",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75067",
            "telephone_number": "972-434-6024",
            "fax_number": "972-434-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRITAGE",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1207022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.

Verify at the official NPI Registry.