NPIMap

Organization Active NPI

Denton Sports & Physical Therapy

  • Physical Therapist
  • Denton, TX
National Provider Identifier
1730159468
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
604720001 Issued in TX
Legal business name
DENTON SPORTS & PHYSICAL THERAPY
Practice address
534 N Elm
Denton, TX 76201
Phone
(940) 566-5714
Fax
(940) 381-0157
NPI assigned
Jan 25, 2006
Last updated
Apr 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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

Authorized official

Name
Daniel J Proctor, LPTNPI 1699821777
Title
Owner
Phone
(940) 566-5714

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 Therapist 225100000X 604720001 TX Primary
Occupational Therapist 225X00000X 509250000 TX

Addresses

Primary practice location

534 N Elm
Denton, TX 76201

Mailing address

534 N Elm
Denton, TX 76201
Phone (940) 566-5714

Other identifiers 1

IdentifierTypeStateIssuer
021697001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100730000242 TX Part B Supplier - Clinic/Group Practice 8628101417 Receives reassigned benefits from 2 practitioners
Practice locations: Denton, TX

National Provider Directory

National Provider Directory

Locations

534 N Elm St
Denton, TX 76201
Phone (940) 566-5714

Practitioners & affiliated clinicians

Practitioners 9

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": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1730159468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 N ELM",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "76201",
            "telephone_number": "940-566-5714",
            "fax_number": "940-381-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 N ELM",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "76201",
            "telephone_number": "940-566-5714",
            "fax_number": "940-381-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTON SPORTS & PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-566-5714",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "604720001",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "509250000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021697001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.