Organization Active NPI

Creative Motion, Inc

  • Physical Therapist
  • Longview, TX
National Provider Identifier
1104155944
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1110948 Issued in TX
Legal business name
CREATIVE MOTION, INC
Practice address
5907 W. Marshall Ave
Longview, TX 75604
Phone
(903) 759-6500
Fax
(903) 759-6500
NPI assigned
Dec 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Authorized official

Name
Mrs. Wanda Bell, PT
Title
Owner
Phone
(903) 759-6500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 1110948 TX
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1110948 TX Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 105205 TX

Addresses

Primary practice location

5907 W. Marshall Ave
Longview, TX 75604

Mailing address

5907 W. Marshall Ave
Longview, TX 75604
Phone (903) 759-6500

Other identifiers 1

IdentifierTypeStateIssuer
0631053MedicaidTX

Other names 1

  • Creative Motion Pediatric Therapy Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278720000000",
    "number": "1104155944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5907 W. MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-759-6500",
            "fax_number": "903-759-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5907 W. MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-759-6500",
            "fax_number": "903-759-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE MOTION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2010-07-10",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-759-6500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "1110948",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1110948",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "105205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0631053",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Motion Pediatric Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.