Individual provider Active NPI

Zane Brannan Richardson, PT,DPT,OCS

  • Physical Therapist
  • Longview, TX
National Provider Identifier
1114448495
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1219022 Issued in TX
Practice address
3133 Good Shepherd Way
Longview, TX 75605-7921
Phone
(903) 380-0072
NPI assigned
Jun 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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 1219022 TX Primary

Addresses

Primary practice location

3133 Good Shepherd Way
Longview, TX 75605-7921

Mailing address

1485 Tall Timbers
Gilmer, TX 75645-8327
Phone (903) 380-0072

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170803002127 TX Practitioner - Physical Therapist in Private Practice 4486925815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chambers Outpatient Rehab Services LLC 15 clinicians

Practice addresses (Care Compare)

405 E Marshall St
Kinetic PT Associates
Gilmer, TX 75644-2331
Phone (903) 402-1052

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
80
Improvement activities
40
Cost
72.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1219022TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chambers Outpatient Rehab Services, LLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients

Locations

405 E Marshall St
Gilmer, TX 75644
Phone (903) 402-1052

1406 Shadywood Ln
Mt Pleasant, TX 75455
Phone (903) 572-6100

1312 S Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 572-6100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1114448495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 TALL TIMBERS",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756458327",
            "telephone_number": "903-380-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 GOOD SHEPHERD WAY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057921",
            "telephone_number": "903-380-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "ZANE",
        "middle_name": "BRANNAN",
        "name_prefix": "Dr.",
        "credential": "PT,DPT,OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1219022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 27, 2017; 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.