Individual provider Active NPI

Rebecca Manning, PT, DPT

  • Physical Therapist
  • Flower Mound, TX
National Provider Identifier
1194356949
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0016526 Issued in CO
Practice address
4040 Bryce LN
Flower Mound, TX 75077-7038
Phone
(940) 241-1215
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 PTL.0016526 CO Primary

Addresses

Primary practice location

4040 Bryce LN
Flower Mound, TX 75077-7038

Mailing address

4040 Bryce LN
Flower Mound, TX 75077-7038
Phone (940) 241-1215

Other names 1

  • Rebecca Russell Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240907000373 TX Practitioner - Physical Therapist in Private Practice 0749720555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0016526COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith S. Tittle, P.T., LLC Physical Therapist CurrentSince Jun 24, 2024 Accepting new patients

Locations

8195 Custer Rd
Ste 100
Frisco, TX 75035
Phone (940) 241-1215

4040 Bryce Ln
Lewisville, TX 75077
Phone (940) 241-1215

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.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1194356949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BRYCE LN",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750777038",
            "telephone_number": "940-241-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 BRYCE LN",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750777038",
            "telephone_number": "940-241-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "REBECCA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "RUSSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.