Iowa Park Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1065332 Issued in TX

Legal business name

IOWA PARK PHYSICAL THERAPY

Practice address

620 West Bank Street
Iowa Park, TX 76367

Phone

(940) 592-5900

Fax

(940) 592-5969

NPI assigned

Jan 22, 2008

Last updated

Jan 22, 2008By 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

Ms. Gina Lynette Blackerby, P.T.NPI 1689679466

Title

Owner/Physical Therapist

Phone

(940) 592-5900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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.

• Gina Lynette Blackerby, P.T.

  • Physical Therapist
  • Iowa Park, TX
  • NPI 1689679466
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1164609186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WEST BANK",
            "city": "IOWA PARK",
            "state": "TX",
            "postal_code": "76367",
            "telephone_number": "940-592-5900",
            "fax_number": "940-592-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WEST BANK STREET",
            "city": "IOWA PARK",
            "state": "TX",
            "postal_code": "76367",
            "telephone_number": "940-592-5900",
            "fax_number": "940-592-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PARK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "BLACKERBY",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "940-592-5900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1065332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1689679466",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hawk Pharmacy, Inc
• Health-E-Connections
• Brie Heaton, PNP
• Raven K Henry, FNP-C
• Iowa Park Consolidated I.S.D
• JKDB Enterprises LLC (a new life home healthcare services)
• Kelly Lynn Jolly, RPH
• Sheena Kaufman
• Cynthia Ann Lee, LBSW-IPR
• Amanda Michele Meyer, NP

• Physical Therapist in Iowa Park, TX
• Providers in Iowa Park, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.