Active NPI
Lisa Rivas, PTA
- Physical Therapy Assistant
- Bedford, TX
National Provider Identifier
1659899367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2119760
- Practice address
- 404 Racquet Club Blvd
Bedford, TX 76022 - Phone
- (682) 738-3056
- NPI assigned
- Sep 1, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 2119760 | TX | Primary |
Addresses
Primary practice location
404 Racquet Club Blvd
Bedford, TX 76022
Mailing address
315 Martha LN
Fort Worth, TX 76126
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2119760 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Small Hands Big Hearts Pediatric Therapy Management Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Home Health Agency
- Fort Worth, TX
- NPI 1992012660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504224000000",
"number": "1659899367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 MARTHA LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 RACQUET CLUB BLVD",
"city": "BEDFORD",
"state": "TX",
"postal_code": "76022",
"telephone_number": "682-738-3056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVAS",
"first_name": "LISA",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-01",
"last_updated": "2017-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2119760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.