Individual provider Active NPI

Harrison E Whittaker

  • Physical Therapist
  • Rowlett, TX
National Provider Identifier
1285204859
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1347052 Issued in TX
Practice address
3005 Lakeview Pkwy Ste 400
Rowlett, TX 75088-3320
Phone
(972) 979-6577
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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
Physical Therapist 225100000X 1347052 TX Primary

Addresses

Primary practice location

3005 Lakeview Pkwy Ste 400
Rowlett, TX 75088-3320

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (803) 812-3656

Other practice location 1

6333 E Mockingbird Ln Ste 139
Dallas, TX 75214-2376
Phone (469) 872-7473

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706001322 TX Practitioner - Physical Therapist in Private Practice 0840692489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1201 Elm St
Suite 121
Dallas, TX 75270-2014
Phone (469) 620-5070

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1347052TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 21, 2021 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jun 21, 2021 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

5615 Colleyville Blvd
Ste 130
Colleyville, TX 76034
Phone (817) 576-0995

9291 Garland Rd
Ste 110
Dallas, TX 75218
Phone (972) 892-4541

1201 Elm St
Ste 121
Dallas, TX 75270
Phone (469) 620-5070

6333 E Mockingbird Ln
Ste 139
Dallas, TX 75214
Phone (469) 782-7786

4015 Lemmon Ave
Dallas, TX 75219
Phone (469) 872-7461

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

125 N MacArthur Blvd
Irving, TX 75061
Phone (972) 887-3318

3005 Lakeview Pkwy
Ste 400
Rowlett, TX 75088
Phone (214) 607-9304

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

809 Woodbridge Pkwy
Ste 200
Wylie, TX 75098
Phone (469) 299-5803

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1285204859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "803-812-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 LAKEVIEW PKWY STE 400",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750883320",
            "telephone_number": "972-979-6577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6333 E Mockingbird Ln Ste 139",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752142376",
            "country_code": "US",
            "telephone_number": "469-872-7473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "HARRISON",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1347052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.