NPIMap

Organization Active NPI

Footsteps and Handprints Pediatric Therapy, LLC

  • Pediatric Physical Therapist
  • Round Rock, TX
National Provider Identifier
1104114412
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1173628 Issued in TX
Legal business name
FOOTSTEPS AND HANDPRINTS PEDIATRIC THERAPY, LLC
Practice address
3000 Joe Dimaggio Blvd
Suite 56
Round Rock, TX 78665
Phone
(512) 218-6955
Fax
(512) 367-5965
NPI assigned
Jul 20, 2011
Last updated
Jan 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Authorized official

Name
Mrs. Emily Ontiveros, PT
Title
Owner
Phone
(512) 218-6955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 1173628 TX Primary

Addresses

Primary practice location

3000 Joe Dimaggio Blvd
Suite 56
Round Rock, TX 78665

Mailing address

3000 Joe Dimaggio Blvd Suite 56
Round Rock, TX 78665
Phone (512) 218-6955

Other identifiers 1

IdentifierTypeStateIssuer
1980005-02MedicaidTX

National Provider Directory

National Provider Directory

Locations

1516 E Palm Valley Blvd
Ste A3
Round Rock, TX 78664
Phone (512) 218-6955

3000 Joe Dimaggio Blvd
Round Rock, TX 78665
Phone (512) 298-2440

3000 Joe Dimaggio Blvd
Ste 56
Round Rock, TX 78665
Phone (512) 218-6955

3001 Joe Dimaggio Blvd
Ste 300
Round Rock, TX 78665
Phone (512) 246-4318

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1104114412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 JOE DIMAGGIO BLVD SUITE 56",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78665",
            "telephone_number": "512-218-6955",
            "fax_number": "512-367-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 JOE DIMAGGIO BLVD",
            "address_2": "SUITE 56",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78665",
            "telephone_number": "512-218-6955",
            "fax_number": "512-367-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTSTEPS AND HANDPRINTS PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "ONTIVEROS",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-218-6955",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1173628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980005-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.