Northwest Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NORTHWEST PHYSICAL THERAPY INC

Practice address

408 Central Dr
Azle, TX 76020-3140

Phone

(817) 444-8827

NPI assigned

Apr 8, 2021

Last updated

Jun 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shane B Wall, PTNPI 1992287619

Title

Owner

Phone

(254) 592-0418

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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.

• Shane Bradley Wall, PT

  • Physical Therapist
  • De Leon, TX
  • NPI 1992287619
  Medicare reassignment NPD Authorized official
• Thomas L Reid Jr., LPT

  • Physical Therapist
  • Azle, TX
  • NPI 1861414898
  NPD

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1114507852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SINGLE TREE RD",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762341850",
            "telephone_number": "254-592-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 CENTRAL DR",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203140",
            "telephone_number": "817-444-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-592-0418",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don V Nguyen, PA
• Thanh Lan Nguyen, PA
• Cheryl Nichols, LMFT ASSOCIATE
• Jean M Noblett, ACNP
• North Texas EMS
• Nurses Etc., Inc. (Main Street Homecare)
• Silvia Nweze-Okudo, DDS
• Offset Investments LLC (Silver Creek Assisted Living)
• Omair Atiq PLLC (GastroCare of North Texas)
• Elfreda Osei

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.

Verify at the official NPI Registry.