Active NPI
Emily Shay Harrell, PT, DPT
- Physical Therapist
- Northlake, TX
National Provider Identifier
1104658772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1396985
- Practice address
- 100 Plaza PL Ste 400
Northlake, TX 76226-3479 - Phone
- (940) 242-2002
- Fax
- (940) 271-0128
- NPI assigned
- Aug 14, 2024
- Last updated
- Aug 14, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1396985 | TX | Primary |
Addresses
Primary practice location
100 Plaza PL Ste 400
Northlake, TX 76226-3479
Mailing address
9101 Timber Oaks Dr
Fort Worth, TX 76179-3247
Phone (817) 308-5659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240827003114 | TX | Practitioner - Physical Therapist in Private Practice | 4486193067 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1396985 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nto Physician Partners, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Grapevine, TX
- NPI 1114443181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1104658772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9101 TIMBER OAKS DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761793247",
"telephone_number": "817-308-5659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PLAZA PL STE 400",
"city": "NORTHLAKE",
"state": "TX",
"postal_code": "762263479",
"telephone_number": "940-242-2002",
"fax_number": "940-271-0128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "EMILY",
"middle_name": "SHAY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-14",
"last_updated": "2024-08-14",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1396985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Northlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.