Individual provider Active NPI

Stephen Swygert Ford, PT, DPT, CSCS

  • Orthopedic Physical Therapist
  • Tyler, TX
National Provider Identifier
1588150270
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1309347 Issued in TX
Practice address
5759 Eagles Nest Blvd Ste 4
Tyler, TX 75703-6231
Phone
(903) 405-4899
Fax
(903) 638-2741
NPI assigned
Jul 5, 2018
Last updated
Dec 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1309347 TX
Physical Therapist 225100000X 9640 SC
Orthopedic Physical Therapist 2251X0800X 1309347 TX Primary

Addresses

Primary practice location

5759 Eagles Nest Blvd Ste 4
Tyler, TX 75703-6231

Mailing address

5759 Eagles Nest Blvd Ste 4
Tyler, TX 75703-6231
Phone (903) 405-4899

Other identifiers 2

IdentifierTypeStateIssuer
8JZ286OtherTXBCBS
390685101MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180925001307 TX Practitioner - Physical Therapist in Private Practice 4981955390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lonestar Physical Therapy and Sports Performance LLCGroup PAC ID 5698144954, 3 clinicians

Practice addresses (Care Compare)

5759 Eagles Nest Blvd
Suite 4
Tyler, TX 75703-6231
Phone (903) 405-4899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1309347TXMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Physical Therapy & Sports Performance LLC Physical Therapist CurrentSince Oct 17, 2022 Accepting new patients

Locations

5759 Eagles Nest Blvd
Ste 4
Tyler, TX 75703
Phone (903) 405-4899

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, 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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1588150270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5759 EAGLES NEST BLVD STE 4",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036231",
            "telephone_number": "903-405-4899",
            "fax_number": "903-638-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5759 EAGLES NEST BLVD STE 4",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036231",
            "telephone_number": "903-405-4899",
            "fax_number": "903-638-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "STEPHEN",
        "middle_name": "SWYGERT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1309347",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9640",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1309347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JZ286",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390685101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.