Individual provider Active NPI

Michael Lavaughn Nash, PT, MSPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1508425554
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3123570 Issued in TX
Practice address
11919 Culebra Road
BLDG. 1, Suite 101
San Antonio, TX 78253
Phone
(210) 828-7757
Fax
(210) 828-7756
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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 3123570 TX Primary

Addresses

Primary practice location

11919 Culebra Road
BLDG. 1, Suite 101
San Antonio, TX 78253

Mailing address

11919 Culebra Road
BLDG. 1, Suite 101
San Antonio, TX 78253
Phone (210) 828-7557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190917000914 TX Practitioner - Physical Therapist in Private Practice 4183953128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
18.23 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
60.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3123570TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stratton Hogan Clinics, Inc. Physical Therapist CurrentSince Aug 5, 2019 Accepting new patients
Stratton Hogan Clinics Inc Physical Therapist CurrentSince Aug 5, 2019 Accepting new patients

Locations

11919 Culebra Rd
Ste 101
San Antonio, TX 78253
Phone (210) 387-5826

Organizations & group practices 2

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1508425554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA ROAD",
            "address_2": "BLDG. 1, SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78253",
            "telephone_number": "210-828-7557",
            "fax_number": "210-828-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA ROAD",
            "address_2": "BLDG. 1, SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78253",
            "telephone_number": "210-828-7757",
            "fax_number": "210-828-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "MICHAEL",
        "middle_name": "LAVAUGHN",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "3123570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.