Individual provider Active NPI

Derek Stapleton, PT, DPT, ATC, LAT

  • Physical Therapist
  • Wylie, TX
National Provider Identifier
1174181887
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1393401 Issued in TX
Practice address
809 Woodbridge Pkwy Ste 200
Wylie, TX 75098-7151
Phone
(469) 838-4074
NPI assigned
May 29, 2019
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P22646 NC
Physical Therapist 225100000X 1393401 TX Primary
Athletic Trainer 2255A2300X LAT-5506 NC

Addresses

Primary practice location

809 Woodbridge Pkwy Ste 200
Wylie, TX 75098-7151

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

12747 Midway Rd Ste 150
Dallas, TX 75244-6304
Phone (972) 979-6577

Other practice location 2

3511 Maitland Dr Ste 102
Raleigh, NC 27610-1239
Phone (984) 325-9030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240701000006 TX Practitioner - Physical Therapist in Private Practice 9032653100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12747 Midway Rd
Suite 150
Dallas, TX 75244-6304
Phone (972) 979-6577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P22646NCMDPhysical Therapist
1393401TXMDPhysical Therapist
LAT-5506NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Multi-Specialty CurrentSince Jun 10, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 10, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

14999 Preston Rd
Ste 108C
Dallas, TX 75254
Phone (214) 231-4154

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

9291 Garland Rd
Ste 110
Dallas, TX 75218
Phone (972) 892-4541

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

5129 N Garland Ave
Ste 600
Garland, TX 75040
Phone (469) 838-4072

491 S Angel Pkwy
Ste 400
Lucas, TX 75002
Phone (972) 737-6161

1515 N Town East Blvd
Ste 500
Mesquite, TX 75150
Phone (214) 273-2903

410 W FM 544
Ste 105
Murphy, TX 75094
Phone (469) 606-5003

308 Coit Rd
Ste 400
Plano, TX 75075
Phone (469) 573-9606

4709 W Parker Rd
Ste 460
Plano, TX 75093
Phone (469) 440-5420

9613 Coit Rd
Ste 110
Plano, TX 75024
Phone (945) 544-4792

1450 E Belt Line Rd
Ste 200
Richardson, TX 75081
Phone (214) 210-4409

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 416-5250

2268 N Lake Shore Dr
Ste 106
Rockwall, TX 75087
Phone (214) 771-7960

3005 Lakeview Pkwy
Ste 400
Rowlett, TX 75088
Phone (214) 607-9304

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

809 Woodbridge Pkwy
Ste 200
Wylie, TX 75098
Phone (469) 299-5803

Organizations & group practices 2

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1174181887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 WOODBRIDGE PKWY STE 200",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987151",
            "telephone_number": "469-838-4074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12747 Midway Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752446304",
            "country_code": "US",
            "telephone_number": "972-979-6577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3511 Maitland Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101239",
            "country_code": "US",
            "telephone_number": "984-325-9030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22646",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1393401",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-5506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.