Individual provider Active NPI

Lauren Ashley Petree, PTA

  • Physical Therapy Assistant
  • Waxahachie, TX
National Provider Identifier
1578857181
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2058970 Issued in TX
Practice address
2460 N I 35 Ste 260
Waxahachie, TX 75165-5278
Phone
(972) 938-3311
NPI assigned
Jun 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2058970 TX Primary

Addresses

Primary practice location

2460 N I 35 Ste 260
Waxahachie, TX 75165-5278

Mailing address

1220 NW County Road 2110
Corsicana, TX 75110-8906
Phone (972) 921-5718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2058970TXMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bir JV LLP PastSince Aug 18, 2019 Accepting new patients

Organizations & group practices 1

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1578857181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 NW COUNTY ROAD 2110",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751108906",
            "telephone_number": "972-921-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N I 35 STE 260",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655278",
            "telephone_number": "972-938-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREE",
        "first_name": "LAUREN",
        "middle_name": "ASHLEY",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2058970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.