Individual provider Active NPI

Grant Robert Stophlet, PT, DPT

  • Physical Therapist
  • McKinney, TX
National Provider Identifier
1053780650
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1265208 Issued in TX
Practice address
3935 S Lake Forest Dr Ste 120
McKinney, TX 75070-1425
Phone
(214) 495-0763
NPI assigned
Sep 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 1265208 TX Primary

Addresses

Primary practice location

3935 S Lake Forest Dr Ste 120
McKinney, TX 75070-1425

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 541-5492

Other practice location 1

200 Beauchamp Ste 112
Princeton, TX 75407-9157
Phone (469) 378-3464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220525000705 TX Practitioner - Physical Therapist in Private Practice 3870970262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Physical Therapy, LLCGroup PAC ID 0648583344, 95 clinicians

Practice addresses (Care Compare)

3935 S Lake Forest Dr
Suite 120
McKinney, TX 75070-1425
Phone (214) 495-0763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1265208TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients
Peak Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

104 E US Highway 80
Ste 180
Forney, TX 75126
Phone (972) 564-3390

3935 S Lake Forest Dr
Ste 120
McKinney, TX 75070
Phone (214) 495-0763

200 Beauchamp
Ste 112
Princeton, TX 75407
Phone (469) 378-3464

Organizations & group practices 2

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": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1053780650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-541-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 S LAKE FOREST DR STE 120",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750701425",
            "telephone_number": "214-495-0763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Beauchamp Ste 112",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "TX",
            "postal_code": "754079157",
            "country_code": "US",
            "telephone_number": "469-378-3464",
            "fax_number": "469-378-3697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOPHLET",
        "first_name": "GRANT",
        "middle_name": "ROBERT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1265208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.