Active NPI
Ann McIntyre
- Physical Therapist
- Willow Park, TX
National Provider Identifier
1639908189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1292769
- Practice address
- 110 Mary Lou Dr Ste 100
Willow Park, TX 76087-8767 - Phone
- (817) 945-3344
- NPI assigned
- Jul 31, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1292769 | TX | Primary |
Addresses
Primary practice location
110 Mary Lou Dr Ste 100
Willow Park, TX 76087-8767
Mailing address
PO Box 932184
Atlanta, GA 31193-2184
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1292769 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1639908189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932184",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311932184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MARY LOU DR STE 100",
"city": "WILLOW PARK",
"state": "TX",
"postal_code": "760878767",
"telephone_number": "817-945-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-31",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1292769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willow Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.