Individual provider Active NPI

John Nguyen, DPT

  • Physical Therapist
  • Weatherford, TX
National Provider Identifier
1407331697
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
965 Hilltop Dr
Weatherford, TX 76086-5845
Phone
(817) 594-7636
NPI assigned
Oct 3, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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 Primary

Addresses

Primary practice location

965 Hilltop Dr
Weatherford, TX 76086-5845

Mailing address

6501 Harris Pkwy
Fort Worth, TX 76132-6102

Other identifiers 1

IdentifierTypeStateIssuer
1308525OtherPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200106002398 TX Practitioner - Physical Therapist in Private Practice 9133553829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportherapy LLC Physical Therapist CurrentSince Sep 17, 2019 Accepting new patients
Sportherapy Southwest, PC Physical Therapist PastSince Sep 17, 2019 Accepting new patients

Locations

2732 W 5th St
Fort Worth, TX 76107
Phone (817) 406-6100

965 Hilltop Dr
Weatherford, TX 76086
Phone (817) 370-9891

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.

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1407331697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761326102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 HILLTOP DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865845",
            "telephone_number": "817-594-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1308525",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.