Active NPI
Stephen Black
- Physical Therapist
- Allen, TX
National Provider Identifier
1356428957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 400 N Allen Dr Ste 104
Allen, TX 75013-2575 - Phone
- (972) 727-1931
- NPI assigned
- Nov 1, 2006
- 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 | Primary |
Addresses
Primary practice location
400 N Allen Dr Ste 104
Allen, TX 75013-2575
Mailing address
7419 Bluefield Dr
Dallas, TX 75248-3011
Phone (972) 702-0584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124444 | Other | TX | LICENSE# |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Clinic Inc | Past | Accepting new patients | |
| Brahms, Cohn & Leb, Inc | Past | Accepting new patients | |
| Crystal Clinic, Inc. | Past | Accepting new patients | |
| Orthopaedics Inc. | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356428957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7419 BLUEFIELD DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752483011",
"telephone_number": "972-702-0584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N ALLEN DR STE 104",
"city": "ALLEN",
"state": "TX",
"postal_code": "750132575",
"telephone_number": "972-727-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "STEPHEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "1124444",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.