Organization Active NPI

Epic Pediatric Therapy, LP

  • Rehabilitation Clinic/Center
  • Allen, TX
National Provider Identifier
1366471450
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
648140018 Issued in TX
Legal business name
EPIC PEDIATRIC THERAPY, LP
Practice address
915 W Exchange Pkwy Ste 100
Allen, TX 75013-7018
Phone
(214) 547-1571
Fax
(817) 789-6849
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Matthew Buckhalter
Title
Cfo
Phone
(470) 464-8000

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 013311 TX
Rehabilitation Clinic/Center 261QR0400X 648140002 TX
Rehabilitation Clinic/Center 261QR0400X 648140015 TX
Rehabilitation Clinic/Center 261QR0400X 648140009 TX
Rehabilitation Clinic/Center 261QR0400X 648140006 TX
Rehabilitation Clinic/Center 261QR0400X 648140018 TX Primary
Rehabilitation Clinic/Center 261QR0400X 648140024 TX
Rehabilitation Clinic/Center 261QR0400X 648140022 TX
Rehabilitation Clinic/Center 261QR0400X 648140005 TX
Rehabilitation Clinic/Center 261QR0400X 648140023 TX
Rehabilitation Clinic/Center 261QR0400X 648140017 TX
Rehabilitation Clinic/Center 261QR0400X 648140021 TX

Addresses

Primary practice location

915 W Exchange Pkwy Ste 100
Allen, TX 75013-7018

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other practice location 1

1000 Saint Louis Ave Ste 102
Fort Worth, TX 76104-3377
Phone (817) 921-5020

Other practice location 2

98 Briggs St Ste 990
San Antonio, TX 78224-1287
Phone (210) 226-9536

Other practice location 3

6601 Montana Ave Ste G&h
El Paso, TX 79925-2155
Phone (915) 838-7604

Other practice location 4

930 W Centerville Rd Ste 930C
Garland, TX 75041-5823
Phone (972) 303-7021

Other identifiers 2

IdentifierTypeStateIssuer
207164901MedicaidTX
149984001MedicaidTX

Other names 1

  • Aveanna Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030423000043 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7012826852 Practice locations: El Paso Texas, TX; San Antonio, TX; Garland, TX; Allen, TX; Fort Worth, TX

Outpatient physical therapy / speech pathology certification: CCN 456606

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
AVEANNA HEALTHCARE
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jun 6, 1989
Last certification
Feb 11, 2020
Ownership / control type
Proprietary
Most recent change of ownership
Nov 11, 1999
Facility address
915 W Exchange Parkwy Ste 100
Allen, TX 75013

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

915 W Exchange Pkwy
Ste 100
Allen, TX 75013
Phone (214) 547-1517

112 SW 8th Ave
Ste 3013
Amarillo, TX 79101
Phone (806) 350-6793

9607 Research Blvd
Ste 675
Austin, TX 78759
Phone (512) 394-0652

5550 Highland Ave
Ste B
Beaumont, TX 77705
Phone (800) 340-4098

600 River Pointe Dr
Ste 200B
Conroe, TX 77304
Phone (936) 588-1067

525 S Carroll Blvd
Denton, TX 76201

6601 Montana Ave
Ste Gh
El Paso, TX 79925
Phone (915) 838-7604

5306 Trail Lake Dr
Fort Worth, TX 76133

1617 Park Place Ave
Ste 110
Ft Worth, TX 76110
Phone (817) 921-5020

1000 Saint Louis Ave
Ste 102
Ft Worth, TX 76104
Phone (817) 921-5020

305 21st St
Ste 251
Galveston, TX 77550

545 Rowlett Rd
Ste B
Garland, TX 75043
Phone (972) 303-7000

930 W Centerville Rd
Ste 930C
Garland, TX 75041
Phone (972) 303-7021

911 W Loop 281
Ste 21112
Longview, TX 75604
Phone (800) 340-4098

18601 Lyndon B Johnson Fwy
Ste 3
Mesquite, TX 75150

4500 W Illinois Ave
Midland, TX 79703
Phone (432) 219-2799

6801 Sanger Ave
Ste 227
Waco, TX 76710

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1366471450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W EXCHANGE PKWY STE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750137018",
            "telephone_number": "214-547-1571",
            "fax_number": "817-789-6849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Saint Louis Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043377",
            "country_code": "US",
            "telephone_number": "817-921-5020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 Briggs St Ste 990",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782241287",
            "country_code": "US",
            "telephone_number": "210-226-9536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6601 Montana Ave Ste G&h",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799252155",
            "country_code": "US",
            "telephone_number": "915-838-7604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 W Centerville Rd Ste 930C",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750415823",
            "country_code": "US",
            "telephone_number": "972-303-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPIC PEDIATRIC THERAPY, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "013311",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140002",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140015",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140009",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140006",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140018",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140024",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140022",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140005",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140023",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140017",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.