Back2Activity Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BACK2ACTIVITY PHYSICAL THERAPY, PLLC

Practice address

1500 N Hobart St
Pampa, TX 79065-4126

Phone

(806) 419-1168

Fax

(806) 419-1149

NPI assigned

Jun 12, 2019

Organization subpart

No

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

Authorized official

Name

Kimberlea Moore, MPT

Title

Physical Therapist/Owner

Phone

(806) 663-2602

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Kimberlea Mae McKandles Moore, MPT

  • Physical Therapist
  • Pampa, TX
  • NPI 1568026557

  Single Specialty

  Medicare reassignment NPD
• Stephanie Elaine Jasso, PTA

  • Physical Therapy Assistant
  • Pampa, TX
  • NPI 1043854649
  NPD (past)

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1043879018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 CHARLES ST",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790653610",
            "telephone_number": "806-419-1168",
            "fax_number": "806-419-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N HOBART ST",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790654126",
            "telephone_number": "806-419-1168",
            "fax_number": "806-419-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK2ACTIVITY PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KIMBERLEA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "806-663-2602",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Louise Ally, RPH
• Michael Anderson
• Emily Lloyd Arrington, D.D.S.
• Assisted Living Concepts Inc
• B & B Pharmacy Inc
• Beth Annette Bagwell, PHARM.D., CGP
• Thomas L Baker, O.D.
• Behavioral Clinic
• Bio-Medical Applications of Texas, Inc.
• Mohannad Basem Bisharat, M.D.

• Physical Therapist in Pampa, TX
• Providers in Pampa, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.