Fort Worth Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1117091 Issued in TX

Legal business name

FORT WORTH PHYSICAL THERAPY PLLC

Practice address

7277 Hawkins View Drive
Fort Worth, TX 76132-3921

Phone

(817) 423-5611

Fax

(817) 423-5577

NPI assigned

Jun 7, 2007

Last updated

Sep 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Suzanne Welch

Title

Credentials Coordinator

Phone

(817) 304-4786

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick C Kimball, PT

  • Physical Therapist
  • Fort Worth, TX
  • NPI 1467610501
  Medicare reassignment
• John Luke McKenzie, P.T.

  • Physical Therapist
  • Fort Worth, TX
  • NPI 1215130117
  Medicare reassignment
• Weldon K Russo, OTR

  • Occupational Therapist
  • Fort Worth, TX
  • NPI 1093918989
  Medicare reassignment

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1598968505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7277 HAWKINS VIEW DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323921",
            "telephone_number": "817-423-5611",
            "fax_number": "817-423-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7277 HAWKINS VIEW DRIVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323921",
            "telephone_number": "817-423-5611",
            "fax_number": "817-423-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "CREDENTIALS COORDINATOR",
        "authorized_official_telephone_number": "817-304-4786",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1117091",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "109622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196088201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Worth Pediatrics, P.a.
• Fort Worth Pediatrics, P.a.
• Fort Worth Perinatal Associates, P.a.
• Fort Worth Personal Medicine, PLLC
• Fort Worth Pharmacy LLC (Fort Worth Pharmacy)
• Fort Worth Physicians PLLC
• Fort Worth Plastic Surgery Center (Texas Surgicare LP)
• Fort Worth Primary Care Providers
• Fort Worth Primary Care, PLLC
• Fort Worth Proctologic Clinic, PA

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.