Active NPI
Will Logan Grimes, PT, DPT
- Physical Therapist
- Burleson, TX
National Provider Identifier
1306374251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1291201
- Practice address
- 811 NE Alsbury Blvd
Burleson, TX 76028-2668 - Phone
- (817) 293-7311
- NPI assigned
- May 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1291201 | TX | Primary |
Addresses
Primary practice location
811 NE Alsbury Blvd
Burleson, TX 76028-2668
Mailing address
4137 Trails End Dr Apt 2023
Fort Worth, TX 76116-0785
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1291201 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495497600000",
"number": "1306374251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4137 TRAILS END DR APT 2023",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761160785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 NE ALSBURY BLVD",
"city": "BURLESON",
"state": "TX",
"postal_code": "760282668",
"telephone_number": "817-293-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "WILL",
"middle_name": "LOGAN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-23",
"last_updated": "2017-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1291201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.