Individual provider Active NPI

John David Kersey

  • Physical Therapist
  • Kingwood, TX
National Provider Identifier
1447093562
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1392365 Issued in TX
Practice address
601 Rockmead Dr Ste 100
Kingwood, TX 77339-2107
Phone
(281) 955-2650
Fax
(281) 955-5875
NPI assigned
Jun 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TX
Physical Therapist 225100000X 1392365 TX Primary

Addresses

Primary practice location

601 Rockmead Dr Ste 100
Kingwood, TX 77339-2107

Mailing address

11800 FM 1960 Rd W
Houston, TX 77065-3840
Phone (281) 955-2650

Other practice location 1

22485 Tomball Pkwy Ste 2100
Houston, TX 77070-1560
Phone (281) 955-2650

Other practice location 2

10425 Huffmeister Rd Ste 320
Houston, TX 77065-3429
Phone (281) 955-2650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705002930 TX Practitioner - Physical Therapist in Private Practice 3779027388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

601 Rockmead Dr
Suite 100
Kingwood, TX 77339-2107
Phone (281) 955-2650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1392365TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Jul 15, 2024 Accepting new patients
Ortholonestar, PLLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

4700 Seton Center Pkwy
Ste 115
Austin, TX 78759
Phone (346) 440-0644

2635 W Baker Rd
Baytown, TX 77521
Phone (281) 337-8550

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

22485 Tomball Pkwy
Ste 2100
Houston, TX 77070
Phone (281) 664-2107

10425 Huffmeister Rd
Ste 320
Houston, TX 77065
Phone (281) 955-2650

11800 FM 1960 Rd W
Houston, TX 77065
Phone (281) 664-2102

601 Rockmead Dr
Ste 100
Kingwood, TX 77339
Phone (281) 359-5115

11520 Northpointe Blvd
Tomball, TX 77377
Phone (281) 955-2650

Interoperability endpoints

  • Direct secure messaging: john.kersey.1@15533.direct.athenahealth.com

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1447093562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653840",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ROCKMEAD DR STE 100",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392107",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22485 Tomball Pkwy Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770701560",
            "country_code": "US",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10425 Huffmeister Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770653429",
            "country_code": "US",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1392365",
            "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 Jun 25, 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.