Individual provider Active NPI

Stephanie Kollister

  • Physical Therapist
  • Kingwood, TX
National Provider Identifier
1396112454
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1263872 Issued in TX
Practice address
23780 Highway 59 N
Kingwood, TX 77339-1529
Phone
(281) 358-1838
Fax
(281) 358-1812
NPI assigned
Aug 25, 2015
Last updated
Aug 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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 1263872 TX Primary

Addresses

Primary practice location

23780 Highway 59 N
Kingwood, TX 77339-1529

Mailing address

23780 Highway 59 N
Kingwood, TX 77339-1529
Phone (281) 358-1838

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151216001854 TX Practitioner - Physical Therapist in Private Practice 6406157494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kingwood Physical Therapy LTDGroup PAC ID 1759488125, 24 clinicians

Practice addresses (Care Compare)

21301 Kuykendahl Rd
Suite B
Spring, TX 77379-2614
Phone (281) 379-2102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1263872TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kingwood Physical Therapy LTD. Physical Therapist CurrentSince Aug 26, 2015 Accepting new patients
Kingwood Physical Therapy LTD Physical Therapist CurrentSince Aug 26, 2015 Accepting new patients
Kingwood Physical Therapy LTD Physical Therapist Past Accepting new patients
Cleveland Physical Therapy LTD Physical Therapist PastSince Mar 1, 2014 Accepting new patients
Kingwood Physical Therapy LTD Past Accepting new patients

Locations

23780 Highway 59 N
Kingwood, TX 77339
Phone (281) 358-1838

6318 FM 1488 Rd
Ste 150
Magnolia, TX 77354
Phone (936) 273-0808

18001 Highway 105 W
Ste 106
Montgomery, TX 77356
Phone (936) 582-2464

21301 Kuykendahl Rd
Ste B
Spring, TX 77379
Phone (281) 379-2102

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1396112454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23780 HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391529",
            "telephone_number": "281-358-1838",
            "fax_number": "281-358-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23780 HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391529",
            "telephone_number": "281-358-1838",
            "fax_number": "281-358-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLISTER",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1263872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.