NPIMap

Organization Active NPI

Phytex Rehabilitation, LLC

Doing business as PhyTEx Rehabilitation & Sports Medicine Associates

  • Physical Therapist
  • Odessa, TX
National Provider Identifier
1053405977
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYTEX REHABILITATION, LLC
Doing business as
PhyTEx Rehabilitation & Sports Medicine Associates
Practice address
2525 N Grandview Ave
Suite 400
Odessa, TX 79761-1600
Phone
(432) 550-4700
Fax
(432) 550-4715
NPI assigned
Oct 3, 2006
Last updated
Mar 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
James C CarlsonNPI 1003837584
Title
Administrator
Phone
(432) 550-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Sports Physical Therapist 2251S0007X NU
Orthopedic Physical Therapist 2251X0800X NU

Addresses

Primary practice location

2525 N Grandview Ave
Suite 400
Odessa, TX 79761-1600

Mailing address

2525 N Grandview Ave
Ste 400
Odessa, TX 79761-1600
Phone (432) 550-4700

Other names 1

  • PhyTEx Rehabilitation & Sports Medicine Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070619000181 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7012016959 Receives reassigned benefits from 12 practitioners
5 other NPIs on this enrollment
Practice locations: Odessa, TX; Pampa, TX; Midland, TX; Alpine, TX

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy Extra - Pampa5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2525 N Grandview Ave
Ste 400
Odessa, TX 79761
Phone (432) 550-4700

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1053405977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 N GRANDVIEW AVE",
            "address_2": "STE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611600",
            "telephone_number": "432-550-4700",
            "fax_number": "432-550-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 N GRANDVIEW AVE",
            "address_2": "SUITE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611600",
            "telephone_number": "432-550-4700",
            "fax_number": "432-550-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYTEX REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "432-550-4700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PhyTEx Rehabilitation & Sports Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PhyTEx Rehabilitation & Sports Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.