Individual provider Active NPI

Mary Creager Hodgkinson, L.P.T.

  • Physical Therapist
  • Victoria, TX
National Provider Identifier
1154451029
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1040434 Issued in TX
Practice address
2806 N Navarro St
Suite K
Victoria, TX 77901-3937
Phone
(361) 582-4667
Fax
(367) 582-4787
NPI assigned
Mar 7, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 1040434 TX Primary

Addresses

Primary practice location

2806 N Navarro St
Suite K
Victoria, TX 77901-3937

Mailing address

2806 N Navarro St
Suite K
Victoria, TX 77901-3918
Phone (361) 582-4667

Other identifiers 3

IdentifierTypeStateIssuer
0054256OtherTXBLUELINK
4411879OtherTXAETNA
82454TOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120207000792 TX Practitioner - Physical Therapist in Private Practice 5193982841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2806 N Navarro St
Suite K
Victoria, TX 77901-3937
Phone (361) 582-4667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1040434TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hodgkinson PC Physical Therapist CurrentSince Nov 29, 2011 Accepting new patients

Locations

2806 N Navarro St
Ste K
Victoria, TX 77901
Phone (361) 582-4667

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154451029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 N NAVARRO ST",
            "address_2": "SUITE K",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013918",
            "telephone_number": "361-582-4667",
            "fax_number": "367-582-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 N NAVARRO ST",
            "address_2": "SUITE K",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013937",
            "telephone_number": "361-582-4667",
            "fax_number": "367-582-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGKINSON",
        "first_name": "MARY",
        "middle_name": "CREAGER",
        "name_prefix": "Ms.",
        "credential": "L.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1040434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUELINK",
            "identifier": "0054256",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4411879",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82454T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.