Individual provider Active NPI

Christopher William Stanley, PT

  • Physical Therapist
  • Longview, TX
National Provider Identifier
1457524431
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1174720 Issued in TX
Practice address
3202 4TH St
Longview, TX 75605-5217
Phone
(903) 753-6635
Fax
(903) 753-1114
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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 61603 OR
Physical Therapist 225100000X 1174720 TX Primary

Addresses

Primary practice location

3202 4TH St
Longview, TX 75605-5217

Mailing address

PO Box 5360
Longview, TX 75608-5360
Phone (903) 753-6635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230228002322 TX Practitioner - Physical Therapist in Private Practice 5193081990 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
Longview Outpatient Physical Therapy LLCGroup PAC ID 9931336070, 4 clinicians

Practice addresses (Care Compare)

402 N Kaufman St
Linden, TX 75563-5234
Phone (903) 753-6635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61603ORMDPhysical Therapist
1174720TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Longview Outpatient Physical Therapy LLC Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients
Pain Managment Joint Venture LLP Physical Therapist PastSince Jun 4, 2023 Accepting new patients
Marshall Physical Therapy, Inc Physical Therapist PastSince Jun 4, 2023 Accepting new patients
Therapeutic Associates Inc Physical Therapist Past Accepting new patients

Locations

402 N Kaufman St
Linden, TX 75563
Phone (903) 665-9500

3202 4th St
Ste 101
Longview, TX 75605

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1457524431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5360",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756085360",
            "telephone_number": "903-753-6635",
            "fax_number": "903-753-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055217",
            "telephone_number": "903-753-6635",
            "fax_number": "903-753-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61603",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1174720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.