Individual provider Active NPI

Kyndall M Brownsworth, DPT

  • Physical Therapist
  • Waco, TX
National Provider Identifier
1538770664
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1335819 Issued in TX
Practice address
5100 Franklin Ave Ste C
Waco, TX 76710-6922
Phone
(254) 732-5981
Fax
(254) 754-2667
NPI assigned
Aug 12, 2020
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 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 1335819 TX Primary

Addresses

Primary practice location

5100 Franklin Ave Ste C
Waco, TX 76710-6922

Mailing address

5100 Franklin Ave Ste C
Waco, TX 76710-6922
Phone (254) 732-5981

Other identifiers 1

IdentifierTypeStateIssuer
1528606357OtherPENDING

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL kbrownsworth@elitesportswaco.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201008001611 TX Practitioner - Physical Therapist in Private Practice 3375963564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1011 S 10TH St
Suite 130
Waco, TX 76706-1384
Phone (254) 294-5924

1428 Wooded Acres Dr
Suite 132
Waco, TX 76710-4466
Phone (254) 262-3322

2450 E Prosper TRL
Suite 10
Prosper, TX 75078-9845
Phone (972) 347-9735

2452 W Loop
340 Suite B
Waco, TX 76711-2405
Phone (254) 265-9988

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1335819TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Multi-Specialty CurrentSince Sep 5, 2022 Accepting new patients
Athletico LTD Multi-Specialty CurrentSince Sep 5, 2022 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

5615 Colleyville Blvd
Ste 130
Colleyville, TX 76034
Phone (817) 576-0995

125 N MacArthur Blvd
Irving, TX 75061
Phone (972) 887-3318

1701 Hewitt Dr
Waco, TX 76712
Phone (254) 294-5950

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1538770664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 FRANKLIN AVE STE C",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767106922",
            "telephone_number": "254-732-5981",
            "fax_number": "254-754-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 FRANKLIN AVE STE C",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767106922",
            "telephone_number": "254-732-5981",
            "fax_number": "254-754-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWNSWORTH",
        "first_name": "KYNDALL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1335819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "1528606357",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kbrownsworth@elitesportswaco.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dwise@elitesportswaco.com",
            "address_1": "5100 Franklin Ave Ste C",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767106922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.