Individual provider Active NPI

Jennifer Ann Ryan

  • Physical Therapist
  • Rockwall, TX
National Provider Identifier
1174307003
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
961 FM 1139
Rockwall, TX 75032-7147
Phone
(903) 456-0947
NPI assigned
Aug 22, 2023
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 NU Primary

Addresses

Primary practice location

961 FM 1139
Rockwall, TX 75032-7147

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Jennifer Dyer Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010000313 TX Practitioner - Physical Therapist in Private Practice 3870948946 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)

809 Woodbridge Pkwy
Suite 200
Wylie, TX 75098-7073
Phone (469) 838-4074

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Aug 14, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

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

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

1215 W Pioneer Pkwy
Ste 200
Grand Prairie, TX 75051
Phone (972) 400-4752

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

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

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 709-4178

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1174307003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 FM 1139",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327147",
            "telephone_number": "903-456-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DYER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.