Organization Active NPI

Neo Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Mesquite, TX
National Provider Identifier
1215667795
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEO PHYSICAL THERAPY LLC
Practice address
1675 Republic Pkwy Ste 101
Mesquite, TX 75150-6902
Phone
(469) 585-2327
NPI assigned
Jun 16, 2022
Last updated
Jun 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Authorized official

Name
Dustin Wade Blankenship, DPTNPI 1194285791
Title
Owner/Physical Therapist
Phone
(469) 585-2327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

1675 Republic Pkwy Ste 101
Mesquite, TX 75150-6902

Mailing address

1801 University Dr
Richardson, TX 75081-3920
Phone (469) 585-2327

National Provider Directory

National Provider Directory
Tax ID family
N E O Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1215667795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 UNIVERSITY DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750813920",
            "telephone_number": "469-585-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 REPUBLIC PKWY STE 101",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506902",
            "telephone_number": "469-585-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEO PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "469-585-2327",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.