Individual provider Active NPI

Kristina R Pearson, PT

  • Physical Therapist
  • Quitman, TX
National Provider Identifier
1376804252
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1179905 Issued in TX
Practice address
1018 E. Goode St., Suite 102
Quitman, TX 75783-2563
Phone
(903) 763-4404
Fax
(903) 763-2550
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1179905 TX Primary

Addresses

Primary practice location

1018 E. Goode St., Suite 102
Quitman, TX 75783-2563

Mailing address

1018 E. Goode St., Suite 102
Quitman, TX 75783-2563
Phone (903) 763-4404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121012000229 TX Practitioner - Physical Therapist in Private Practice 1951550672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quitman Health Services PLLCGroup PAC ID 6800034331, 5 clinicians

Practice addresses (Care Compare)

1018 E Goode St
Suite 102
Quitman, TX 75783-1641

1018 E Goode St
Suite 102
Quitman, TX 75783-2563
Phone (903) 763-4404

606 E Goode St
Suite 400
Quitman, TX 75783-2563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1179905TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quitman Health Services, PLLC Physical Therapist CurrentSince Sep 2, 2023 Accepting new patients

Locations

1018 E Goode St
Ste 102
Quitman, TX 75783
Phone (903) 763-4404

606 E Goode St
Ste 400
Quitman, TX 75783
Phone (903) 763-4404

1018 E Goode St
#102
Quitman, TX 75783
Phone (903) 763-4404

Organizations & group practices 1

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1376804252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 E. GOODE ST., SUITE 102",
            "city": "QUITMAN",
            "state": "TX",
            "postal_code": "757832563",
            "telephone_number": "903-763-4404",
            "fax_number": "903-763-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 E. GOODE ST., SUITE 102",
            "city": "QUITMAN",
            "state": "TX",
            "postal_code": "757832563",
            "telephone_number": "903-763-4404",
            "fax_number": "903-763-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "KRISTINA",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1179905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quitman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.