Individual provider Active NPI

Craig Frank Neffendorf, PT

  • Physical Therapist
  • Blanco, TX
National Provider Identifier
1487660437
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1099380 Issued in TX
Practice address
11 Main St
Blanco, TX 78606-4900
Phone
(830) 833-3068
Fax
(830) 833-3133
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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 1099380 TX Primary

Addresses

Primary practice location

11 Main St
Blanco, TX 78606-4900

Mailing address

11 Main St
Blanco, TX 78606-4900
Phone (830) 833-3068

Other identifiers 2

IdentifierTypeStateIssuer
184047201MedicaidTX
659911OtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000452 TX Practitioner - Physical Therapist in Private Practice 4789605775 Reassigns benefits to 1 organization
Practice locations: Blanco, TX

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1500 4TH St
Unit 5
Blanco, TX 78606-2322
Phone (830) 833-3068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1099380TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blanco Physical Therapy Physical Therapist CurrentSince Apr 1, 2010 Accepting new patients
Blanco Physical Therapy, LLC Physical Therapist CurrentSince Jan 1, 2024 Accepting new patients
Cole Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

825 4th St
Blanco, TX 78606
Phone (361) 882-7300

1500 4th St
Unit 5
Blanco, TX 78606
Phone (808) 634-9817

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

Organizations & group practices 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1487660437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MAIN ST",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786064900",
            "telephone_number": "830-833-3068",
            "fax_number": "830-833-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAIN ST",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786064900",
            "telephone_number": "830-833-3068",
            "fax_number": "830-833-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEFFENDORF",
        "first_name": "CRAIG",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1099380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184047201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "659911",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.