Glory Days Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

GLORY DAYS PHYSICAL THERAPY, LLC

Practice address

1615 Dorchester Dr Ste 108
Plano, TX 75075-6329

Phone

(972) 212-4019

Fax

(972) 546-4793

NPI assigned

Aug 30, 2022

Organization subpart

No

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

Authorized official

Name

Hunter Mandeville, PT DPTNPI 1144585480

Title

Owner

Phone

(903) 821-8799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hunter Mandeville, DPT

  • Physical Therapist
  • Plano, TX
  • NPI 1144585480
  Medicare reassignment Care Compare group NPD Authorized official
• Cassandra Thomas Mandeville, PT, DPT

  • Physical Therapist
  • Plano, TX
  • NPI 1396178422
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1629798657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 CLERMONT CIR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235307",
            "telephone_number": "903-821-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DORCHESTER DR STE 108",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756329",
            "telephone_number": "972-212-4019",
            "fax_number": "972-546-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORY DAYS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "MANDEVILLE",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-821-8799",
        "authorized_official_credential": "PT DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khara Glick, SLP-A
• Robert Allen Glick, D.O.
• Geoffrey Glynn Glidden, MD
• Global Chiropractic Plano/Frisco
• Global Molecular Labs, LLC
• Lori Shannon Glowacki, M.D.
• GM Diagnostics, PLLC
• GN Medical Center, Inc.
• GNC Medical, PA
• Caroline Go, PT, DPT

• Physical Therapist in Plano, TX
• Providers in Plano, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.