NPIMap

Organization Active NPI

Pedi Spot LLC

  • Rehabilitation Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1235338153
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PEDI SPOT LLC
Practice address
1617 Park Place Ave, #110
Fort Worth, TX 76110-1300
Phone
(817) 921-5020
Fax
(817) 921-5022
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Authorized official

Name
Neil E. Casey
Title
President & Ceo
Phone
(972) 596-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

1617 Park Place Ave, #110
Fort Worth, TX 76110-1300

Mailing address

4965 Preston Park Blvd, #200
Plano, TX 75093-3649

National Provider Directory

National Provider Directory
Tax ID family
Pedi Spot LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1235338153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 PRESTON PARK BLVD, #200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 PARK PLACE AVE, #110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101300",
            "telephone_number": "817-921-5020",
            "fax_number": "817-921-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDI SPOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "972-596-7700"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.