Individual provider Active NPI

Reginald Van Velzen, PT

  • Physical Therapist
  • Lubbock, TX
National Provider Identifier
1225308745
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1214108 Issued in TX
Practice address
5217 82ND St Unit 104
Lubbock, TX 79424-2800
Phone
(806) 687-4311
NPI assigned
Jan 2, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1214108 TX Primary
Physical Therapist 225100000X 9648 AZ

Addresses

Primary practice location

5217 82ND St Unit 104
Lubbock, TX 79424-2800

Mailing address

194 Merritt St. West
Welland, ONTARIO L3C 4T9
CA
Phone (905) 641-7675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120507000172 TX Practitioner - Physical Therapist in Private Practice 9638331762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9648AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Physical Therapy Specialists CurrentSince Feb 12, 2024 Accepting new patients
Elevate Performance LLC Current Accepting new patients
Texas Physical Therapy Specialists, Inc. Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients
McCombs and Associates Physical Therapy, Inc. Physical Therapist PastSince Mar 5, 2023 Accepting new patients

Locations

6501 S Congress Ave
Ste 301
Austin, TX 78745
Phone (512) 270-2060

11150 Research Blvd
Ste 212
Austin, TX 78759
Phone (512) 794-8863

1920 S Austin Ave
Georgetown, TX 78626

1789 S Bagdad Rd
Ste 102
Leander, TX 78641
Phone (512) 337-8970

1324 E Common St
Ste 307
New Braunfels, TX 78130
Phone (830) 625-7310

Organizations & group practices 4

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": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1225308745",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "194 MERRITT ST. WEST",
            "city": "WELLAND",
            "state": "ONTARIO",
            "postal_code": "L3C 4T9",
            "telephone_number": "905-641-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5217 82ND ST UNIT 104",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242800",
            "telephone_number": "806-687-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VELZEN",
        "first_name": "REGINALD",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-02",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1214108",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.