Individual provider Active NPI

Misty Blasingame, PT

  • Physical Therapist
  • Richardson, TX
National Provider Identifier
1457761074
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1183820 Issued in TX
Practice address
510 N Coit Rd
2035 Promenade Center
Richardson, TX 75080-5446
Phone
(972) 437-2048
Fax
(972) 480-8514
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2014

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 1183820 TX Primary

Addresses

Primary practice location

510 N Coit Rd
2035 Promenade Center
Richardson, TX 75080-5446

Mailing address

510 N Coit Rd
2035 Promenade Center
Richardson, TX 75080-5446
Phone (972) 437-2048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1457761074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N COIT RD",
            "address_2": "2035 PROMENADE CENTER",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805446",
            "telephone_number": "972-437-2048",
            "fax_number": "972-480-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N COIT RD",
            "address_2": "2035 PROMENADE CENTER",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805446",
            "telephone_number": "972-437-2048",
            "fax_number": "972-480-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASINGAME",
        "first_name": "MISTY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1183820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.