Paradigm Physical Therapy & Sports Science Center

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

613030000 Issued in TX

Legal business name

PARADIGM PHYSICAL THERAPY & SPORTS SCIENCE CENTER

Practice address

701 N Grant Ave
Odessa, TX 79761-4504

Phone

(432) 580-3300

Fax

(432) 580-0505

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William H Dodson, PT, DSC, OCS, CHTNPI 1801809413

Title

Physical Therapist,Owner

Phone

(432) 580-3300

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William H Dodson, PT, DSC, OCS, CHT

  • Physical Therapist
  • Odessa, TX
  • NPI 1801809413
  Medicare reassignment Care Compare group Authorized official
• David William Davison, MD

  • Family Medicine Physician
  • Odessa, TX
  • NPI 1548289275
  Care Compare group

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1295853836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N GRANT AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614504",
            "telephone_number": "432-580-3300",
            "fax_number": "432-580-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N GRANT AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614504",
            "telephone_number": "432-580-3300",
            "fax_number": "432-580-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADIGM PHYSICAL THERAPY & SPORTS SCIENCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST,OWNER",
        "authorized_official_telephone_number": "432-580-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, DSC, OCS, CHT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1072692",
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "TX",
            "license": "613030000",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0039729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0060DL",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID (SECONDARY)",
            "identifier": "021716801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "144906802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "456783",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID (PRIMARY)",
            "identifier": "062884401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "144906801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neha Bharadwaj Panchagnula, MBBS
• Binay Kumar Panjiyar, MD GCSRT
• Pankaj V. Patel, M.D.,P.a.
• Anupamdeep Pannu
• Amanda Lynn Paradeaux, DNP, FNP-C
• Andrianna Pardo
• Stacy Parker
• Darrell Scott Parsons, M.D.
• Daisha Rae Partlow, FNP-C
• Lada Pascar

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Odessa, TX
• Providers in Odessa, TX by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.