Mandy Withers

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1201 S Ih 35 Ste 105
Round Rock, TX 78664-6646

Phone

(512) 310-7665

Fax

(512) 310-9228

NPI assigned

Oct 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mandy Hunt Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Imago Rehab, Inc

  • Neurorehabilitation Occupational Therapist
  • Lowell, MA
  • NPI 1205407236

  TX

  Medicare reassignment
• Reavis Rehab & Wellness Center, Inc.

  • Rehabilitation Clinic/Center
  • Round Rock, TX
  • NPI 1265448054
  NPD (past)

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1417590258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S INTERSTATE 35 STE 105",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646646",
            "telephone_number": "512-310-7665",
            "fax_number": "512-310-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S IH 35 STE 105",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646646",
            "telephone_number": "512-310-7665",
            "fax_number": "512-310-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "MANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1328802",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094474602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "HUNT",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hollie Wingate, BCBA
• Bobby John Winner, LSA
• Eridian Winter, LMFT-A
• Jakob Ryan Wisbrock
• Araceli H. Wisnoski, B.S., R.PH.
• Within Her LLC
• Charlene Frances Witteneberg, DPA LPC MA MS NCC
• Allison Mary Wolf, FNP
• Womens Health Associates of Central Texas
• Leora Wong, BA, MS

• Physical Therapist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.