NPIMap

Individual provider Active NPI

Raymond A Till, P.T.

  • Orthopedic Physical Therapist
  • Grapevine, TX
National Provider Identifier
1255601415
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1034007 Issued in TX
Practice address
1643 Lancaster Dr
Suite 100
Grapevine, TX 76051-3593
Phone
(817) 329-2524
Fax
(817) 329-2685
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1034007 TX Primary

Addresses

Primary practice location

1643 Lancaster Dr
Suite 100
Grapevine, TX 76051-3593

Mailing address

1643 Lancaster Dr
Suite 100
Grapevine, TX 76051-3593
Phone (817) 329-2524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1034007TXMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Nephrology Associates Past Accepting new patients
Bir JV LLP Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 2

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1255601415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 LANCASTER DR",
            "address_2": "SUITE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513593",
            "telephone_number": "817-329-2524",
            "fax_number": "817-329-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 LANCASTER DR",
            "address_2": "SUITE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513593",
            "telephone_number": "817-329-2524",
            "fax_number": "817-329-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "RAYMOND",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1034007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.