Individual provider Active NPI

Randall Dolan Kinslow, PT, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1336924356
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1123 N Main Ave Ste 211
San Antonio, TX 78212-4738
Phone
(210) 226-2101
Fax
(210) 226-6445
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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 5391 AR
Physical Therapist 225100000X TX Primary

Addresses

Primary practice location

1123 N Main Ave Ste 211
San Antonio, TX 78212-4738

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

1880 Airport Rd Ste C
Hot Springs, AR 71913-2117
Phone (501) 781-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250522000290 TX Practitioner - Physical Therapist in Private Practice 8628597770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

12315 Judson Rd
Suite 310And312
Live Oak, TX 78233-3277
Phone (210) 599-3090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5391ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Apr 14, 2025 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Apr 14, 2025 Accepting new patients
Joint Effort Physical Therapy Inc PastSince Sep 1, 2023 Accepting new patients

Locations

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

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

12315 Judson Rd
Ste 310
Live Oak, TX 78233
Phone (210) 599-3090

1123 N Main Ave
Ste 211
San Antonio, TX 78212
Phone (210) 226-2101

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

Organizations & group practices 3

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1336924356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 N MAIN AVE STE 211",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124738",
            "telephone_number": "210-226-2101",
            "fax_number": "210-226-6445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1880 Airport Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Hot Springs",
            "state": "AR",
            "postal_code": "719132117",
            "country_code": "US",
            "telephone_number": "501-781-2701",
            "fax_number": "501-781-2702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSLOW",
        "first_name": "RANDALL",
        "middle_name": "DOLAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5391",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.