Keri Lyn Gustavsen, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1161526 Issued in TX

Practice address

100 Country Club Rd Ste 120
Argyle, TX 76226-2358

Phone

(940) 464-0055

Fax

(940) 464-7755

NPI assigned

Jul 6, 2006

Last updated

Nov 4, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hunt and Tate Associates LLCGroup PAC ID 1153739776, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hunt and Tate Associates, L.L.C.

  dba Ascend Physical Therapy and Wellness

  • Orthopedic Physical Therapist
  • Longview, TX
  • NPI 1427648138
  Medicare reassignment Care Compare group NPD
• Colleyville Physical Therapy and Sports Rehab, PC

  • Physical Therapist
  • Colleyville, TX
  • NPI 1134158371
  NPD (past)
• Stay Strong Physical Therapy - Argyle PLLC

  • Physical Therapy Clinic/Center
  • Dallas, TX
  • NPI 1710129192
  NPD (past)
• Stay Strong Physical Therapy-Argyle, PLLC

  • Physical Therapy Clinic/Center
  • Argyle, TX
  • NPI 1285818831
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1063444743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762260372",
            "telephone_number": "940-464-0055",
            "fax_number": "940-464-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTRY CLUB RD STE 120",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762262358",
            "telephone_number": "940-464-0055",
            "fax_number": "940-464-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSEN",
        "first_name": "KERI",
        "middle_name": "LYN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1161526",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1161526",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "825T48",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00852663",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Gilliam
• Richard Gordon, LCSW
• Gracenest Healthcare LLC
• Kassidy Grames, LM
• Wendy Robinson Gruver, M.S.
• David Bert Hall, D.O.
• Kadie Hawley
• Erin Haytaian, APRN
• Head Strong & Ready Texas (Head Strong & Ready)
• Healing Encounters, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.