Individual provider Active NPI

Cynthia Anne Mack, PT

  • Physical Therapist
  • Kingwood, TX
National Provider Identifier
1740309434
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1195890 Issued in TX
Practice address
605 Rockmead Dr
Kingwood, TX 77339-2254
Phone
(281) 348-9588
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT9541 OH
Physical Therapist 225100000X 1195890 TX Primary

Addresses

Primary practice location

605 Rockmead Dr
Kingwood, TX 77339-2254

Mailing address

605 Rockmead Dr
Kingwood, TX 77339-2254
Phone (281) 348-9588

Other identifiers 2

IdentifierTypeStateIssuer
2765235MedicaidOH
P00411838OtherOHMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000434 TX Practitioner - Physical Therapist in Private Practice 5597862797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theraworks IncGroup PAC ID 9133039647, 36 clinicians

Practice addresses (Care Compare)

605 Rockmead Dr
Suite 200
Kingwood, TX 77339-2255
Phone (281) 348-9588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9541OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraworks Inc Physical Therapist CurrentSince Sep 1, 2010 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist CurrentSince Sep 1, 2010 Accepting new patients
Theraworks Inc Physical Therapist Current Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist CurrentSince Sep 1, 2010 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist Past Accepting new patients

Locations

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

3050 Dowlen Rd
Ste L
Beaumont, TX 77706
Phone (409) 861-4606

5514 Atascocita Rd
Humble, TX 77346
Phone (281) 441-5371

605 Rockmead Dr
Ste 200
Kingwood, TX 77339
Phone (281) 348-9588

4899 Highway 6
Ste 212C
Missouri City, TX 77459
Phone (346) 371-2121

6807 Emmett F Lowry Expy
Ste 103
Texas City, TX 77591
Phone (409) 935-2840

711 W Bay Area Blvd
Ste 608
Webster, TX 77598
Phone (281) 338-1273

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1740309434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 ROCKMEAD DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392254",
            "telephone_number": "281-348-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 ROCKMEAD DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392254",
            "telephone_number": "281-348-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "CYNTHIA",
        "middle_name": "ANNE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT9541",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1195890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2765235",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00411838",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.