Active NPI
Kelly Gomez, DPT, PT
- Physical Therapist
- Lubbock, TX
National Provider Identifier
1376009316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1279749
- Practice address
- 5225 S Loop 289 Ste 210
Lubbock, TX 79424-1319 - Phone
- (806) 780-4180
- NPI assigned
- Feb 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 1279749 | TX | Primary |
Addresses
Primary practice location
5225 S Loop 289 Ste 210
Lubbock, TX 79424-1319
Mailing address
305 NE Loop 820
Business Tower 1, Suite 200
Hurst, TX 76053
Phone (817) 292-8787
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1279749 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Health Services, Inc. | Past | Accepting new patients | |
| Epic Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Houston, TX
- NPI 1407922701
-
- Home Health Agency
- Lubbock, TX
- NPI 1659447944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550102400000",
"number": "1376009316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 820",
"address_2": "BUSINESS TOWER 1, SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "76053",
"telephone_number": "817-292-8787",
"fax_number": "817-789-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 S LOOP 289 STE 210",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794241319",
"telephone_number": "806-780-4180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "KELLY",
"credential": "DPT, PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-14",
"last_updated": "2019-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1279749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.