NPIMap

Organization Active NPI

2 M Polhemus LLC

  • Physical Therapist
  • Wimberley, TX
National Provider Identifier
1467750554
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
2 M POLHEMUS LLC
Doing business as
Wimberley Physical Therapy
Practice address
14100 Ranch Road 12
#100
Wimberley, TX 78676-5354
Phone
(830) 221-5423
NPI assigned
Mar 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Matthew Polhemus, PTNPI 1164502837
Title
Owner
Phone
(512) 847-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

14100 Ranch Road 12
#100
Wimberley, TX 78676-5354

Mailing address

14100 Ranch Road 12
#100
Wimberley, TX 78676-5354
Phone (512) 847-3300

Other names 1

  • Wimberley Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120111000036 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6103092390 Receives reassigned benefits from 8 practitioners
Practice locations: Wimberley, TX; San Marcos, TX

National Provider Directory

National Provider Directory

Locations

350 Stagecoach Trl
San Marcos, TX 78666
Phone (512) 886-3701

111 River Rd
Ste 200
Wimberley, TX 78676

14100 Ranch Road 12
Unit 100
Wimberley, TX 78676
Phone (512) 847-3300

111 River Rd
Bldg 200
Wimberley, TX 78676
Phone (512) 847-3300

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1467750554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 RANCH ROAD 12",
            "address_2": "#100",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765354",
            "telephone_number": "512-847-3300",
            "fax_number": "512-847-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 RANCH ROAD 12",
            "address_2": "#100",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765354",
            "telephone_number": "830-221-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2 M POLHEMUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "POLHEMUS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-847-3300",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wimberley Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wimberley, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.