Individual provider Active NPI

Dennis George Connelly, PT

  • Physical Therapist
  • Weatherford, TX
National Provider Identifier
1548346182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1020766 Issued in TX
Practice address
141 College Park Dr
Weatherford, TX 76086-6211
Phone
(817) 341-3600
Fax
(817) 599-8181
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1020766 TX Primary

Addresses

Primary practice location

141 College Park Dr
Weatherford, TX 76086-6211

Mailing address

141 College Park Dr
Weatherford, TX 76086-6211
Phone (817) 341-3600

Other identifiers 2

IdentifierTypeStateIssuer
8T1495OtherTXBLUE CROSS BLUE SHIELD
5981572OtherTXAETNA INSURANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630000571 TX Practitioner - Physical Therapist in Private Practice 6103735147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6530 W Hwy 377 100
Tolar Sports Therapy
Tolar, TX 76476-1500
Phone (940) 490-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1020766TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Something Amazing Home Therapy, LLC CurrentSince Jun 23, 2020 Accepting new patients
Pathway Rehabilitation LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1140 FM 1189
Ste 115
Millsap, TX 76066
Phone (254) 485-1482

6530 W Highway 377
Ste 100
Tolar, TX 76476
Phone (940) 490-0023

102 Taylor Rd
Weatherford, TX 76087
Phone (254) 485-1482

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, 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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548346182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 COLLEGE PARK DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866211",
            "telephone_number": "817-341-3600",
            "fax_number": "817-599-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 COLLEGE PARK DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866211",
            "telephone_number": "817-341-3600",
            "fax_number": "817-599-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "DENNIS",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1020766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8T1495",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "5981572",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.