Tricia Denise Blalock, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1098242 Issued in TX

Practice address

2001 N Jefferson Ave
Mt Pleasant, TX 75455-2338

Phone

(903) 434-8011

NPI assigned

Mar 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Therapy Group LLCGroup PAC ID 0648636597, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Active Therapy Group LLC

  • Physical Therapy Clinic/Center
  • Waco, TX
  • NPI 1326745647

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1609260231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STONE CREEK RANCH RD",
            "city": "MC GREGOR",
            "state": "TX",
            "postal_code": "766573771",
            "telephone_number": "903-573-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N JEFFERSON AVE",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754552338",
            "telephone_number": "903-434-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "TRICIA",
        "middle_name": "DENISE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1098242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan S Bellaw, PA-C
• Jill Marie Bennett, PHD
• Better Minds Psychology, PLLC
• Bio-Medical Applications of Texas, Inc.
• Elizabeth Nicole Bird, CRNA
• Margaret Renee Blare, R.PH.
• Kelley Diane Blevins, LPTA
• Lynda Elizabeth Bockmon, ANP-BC, ACNP-BC
• Tammy Lynn Boggs, LPN
• John D Boldan Jr., OD

• All providers in Mt Pleasant, TX
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.