Organization Active NPI

Mary Ellen Nguyen

Doing business as Reform Physical Therapy and Wellness

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1346875275
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARY ELLEN NGUYEN
Doing business as
Reform Physical Therapy and Wellness
Practice address
16250 Knoll Trail Dr Ste 101
Dallas, TX 75248-2868
Phone
(214) 679-3891
Fax
(469) 405-2994
NPI assigned
Mar 11, 2020
Last updated
Mar 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Authorized official

Name
Mary Ellen Solis Nguyen, MS, PTNPI 1568756583
Title
Owner, Ceo, Physical Therapist
Phone
(214) 679-3891

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

16250 Knoll Trail Dr Ste 101
Dallas, TX 75248-2868

Mailing address

PO Box 835613
Richardson, TX 75083-5613
Phone (214) 679-3891

Other names 1

  • Reform Physical Therapy and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200416002869 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5597195404 Receives reassigned benefits from 6 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

16250 Knoll Trail Dr
Ste 101
Dallas, TX 75248
Phone (214) 679-3891

6911 Frankford Rd
Dallas, TX 75252

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741392000000",
    "number": "1346875275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835613",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750835613",
            "telephone_number": "214-679-3891",
            "fax_number": "469-405-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 KNOLL TRAIL DR STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752482868",
            "telephone_number": "214-679-3891",
            "fax_number": "469-405-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ELLEN NGUYEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_middle_name": "SOLIS",
        "authorized_official_title_or_position": "OWNER, CEO, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "214-679-3891",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reform Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; 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.