Neo Physical Therapy LLC

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 10, 2022

Last updated

Jun 10, 2022By the provider in NPPES

Organization subpart

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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.

• Neo Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Mesquite, TX
  • NPI 1215667795
  NPD tax ID

Locations

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.

• Dustin W Blankenship, PT

  • Physical Therapist
  • Cedar Hill, TX
  • NPI 1194285791
  Medicare reassignment NPD Authorized official
• Victoria Bradshaw, PT, DPT

  • Physical Therapist
  • Carrollton, TX
  • NPI 1578134490
  Medicare reassignment NPD

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1225768500",
    "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": "2022-06-10",
        "last_updated": "2022-06-10",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ne3 Enterprises, LLC (Puzzle Piece Kids)
• Oby Betrice Nebe, RN
• Neema Psychiatry PLLC
• Connie Nellum, NURSE PRACTITIONER
• Neo Physical Therapy LLC
• Ness Home Health Service, LLC
• Taquasha Nettles
• Network Provider Associates, P.C. (Creek Crossing Dental Care and Orthodontics)
• Lauren Madison Neugin
• New Beginning Pediatric Therapy / Academic Achievement

• Physical Therapy Clinic/Center in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.