Active NPI
Kevin Lacke, DPT, CSCS
- Physical Therapist
- Bastrop, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1322490
- Practice address
- 747 Texas 71 Frontage Rd
Suite B-200
Bastrop, TX 78602 - Phone
- (512) 920-6512
- NPI assigned
- Aug 28, 2019
- Sex
- Male
- 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 | 1322490 | TX | Primary |
Addresses
Primary practice location
747 Texas 71 Frontage Rd
Suite B-200
Bastrop, TX 78602
Mailing address
6611 Zequiel Dr
Austin, TX 78744-7231
Phone (508) 446-1756
Other practice location 1
102 Wonder World Dr Ste 401
San Marcos, TX 78666-6072
Phone (512) 262-9578
Other practice location 2
5601 Brodie Ln Ste 640
Sunset Valley, TX 78745-2551
Phone (512) 580-3055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy Beth Hopkins MPT PC Dba Your Personal Best PT | Physical Therapist | Current | Accepting new patients |
Locations
2500 W William Cannon Dr
Ste 409
Austin, TX 78745
Phone (512) 852-8434
747 Highway 71 W
Ste B200
Bastrop, TX 78602
Phone (512) 920-6512
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.
-
- Physical Therapist
- Copperas Cove, TX
- NPI 1275165631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619740800000",
"number": "1114575529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6611 ZEQUIEL DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787447231",
"telephone_number": "508-446-1756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 TEXAS 71 FRONTAGE RD",
"address_2": "SUITE B-200",
"city": "BASTROP",
"state": "TX",
"postal_code": "78602",
"telephone_number": "512-920-6512"
}
],
"practiceLocations": [
{
"address_1": "102 Wonder World Dr Ste 401",
"address_purpose": "LOCATION",
"city": "San Marcos",
"state": "TX",
"postal_code": "786666072",
"country_code": "US",
"telephone_number": "512-262-9578",
"fax_number": "512-782-2989",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5601 Brodie Ln Ste 640",
"address_purpose": "LOCATION",
"city": "Sunset Valley",
"state": "TX",
"postal_code": "787452551",
"country_code": "US",
"telephone_number": "512-580-3055",
"fax_number": "512-580-3056",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LACKE",
"first_name": "KEVIN",
"credential": "DPT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-28",
"last_updated": "2021-04-30",
"certification_date": "2021-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1322490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.