NPIMap

Organization Active NPI

Tillman Physical Therapy & Sports Training

  • Physical Therapist
  • Cedar Park, TX
National Provider Identifier
1477703114
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3106512 Issued in TX
Legal business name
TILLMAN PHYSICAL THERAPY & SPORTS TRAINING
Practice address
2519 S Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964
Phone
(512) 331-6200
Fax
(513) 331-6384
NPI assigned
Sep 30, 2008
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Authorized official

Name
Cherly Faubion, DPT
Title
DPT
Phone
(512) 331-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3106512 TX Primary

Addresses

Primary practice location

2519 S Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964

Mailing address

2519 South Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964
Phone (512) 331-6200

Other identifiers 1

IdentifierTypeStateIssuer
3106512OtherTXPHYSICAL THERAPY LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Tillman Physical Therap2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2519 S Lakeline Blvd
Ste 100
Cedar Park, TX 78613
Phone (512) 331-6200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1477703114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 SOUTH LAKELINE BLVD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "513-331-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 S LAKELINE BLVD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "513-331-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLMAN PHYSICAL THERAPY & SPORTS TRAINING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "FAUBION",
        "authorized_official_first_name": "CHERLY",
        "authorized_official_title_or_position": "DPT",
        "authorized_official_telephone_number": "512-331-6200",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "3106512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY  LICENSE",
            "identifier": "3106512",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.