NPIMap

Organization Active NPI

Pedi Spot LLC

  • Rehabilitation Clinic/Center
  • Tyler, TX
National Provider Identifier
1053510974
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PEDI SPOT LLC
Practice address
4801 Troup Hwy
Suite 800
Tyler, TX 75703-2356
Phone
(903) 939-2800
Fax
(903) 581-7057
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Authorized official

Name
Neil E. Casey
Title
President & Ceo
Phone
(972) 596-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

4801 Troup Hwy
Suite 800
Tyler, TX 75703-2356

Mailing address

4965 Preston Park Blvd
Suite 200
Plano, TX 75093-5180

National Provider Directory

National Provider Directory
Tax ID family
Pedi Spot LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203292800000",
    "number": "1053510974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 PRESTON PARK BLVD",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY",
            "address_2": "SUITE 800",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032356",
            "telephone_number": "903-939-2800",
            "fax_number": "903-581-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDI SPOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2008-02-18",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "972-596-7700"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.