NPIMap

Organization Active NPI

Ampic Rehab, PLLC

Doing business as Ampic Physical Therapy

  • Physical Therapist
  • Plano, TX
National Provider Identifier
1699059394
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1178901 Issued in TX
Legal business name
AMPIC REHAB, PLLC
Doing business as
Ampic Physical Therapy
Practice address
7704 San Jacinto PL
Suite 200
Plano, TX 75024-3202
Phone
(214) 733-7869
NPI assigned
Sep 29, 2011
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Dr. Mark Brennan Russo, PT, DPTNPI 1669784419
Title
Owner/Physical Therapist
Phone
(214) 733-7869

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 1178901 TX Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 1198529 TX

Addresses

Primary practice location

7704 San Jacinto PL
Suite 200
Plano, TX 75024-3202

Mailing address

4510 Druid LN
#111
Dallas, TX 75205-4717
Phone (214) 733-7869

Other names 1

  • Ampic Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1699059394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 DRUID LN",
            "address_2": "#111",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752054717",
            "telephone_number": "214-733-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7704 SAN JACINTO PL",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243202",
            "telephone_number": "214-733-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPIC REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-29",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BRENNAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "214-733-7869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1178901",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1198529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ampic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.