Individual provider Active NPI

James A Mallard

  • Physical Therapist
  • Arlington, TX
National Provider Identifier
1750415907
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1144624 Issued in TX
Practice address
6702 W Poly Webb Rd
Arlington, TX 76016-3615
Phone
(817) 478-0095
Fax
(817) 478-7628
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1144624 TX Primary

Addresses

Primary practice location

6702 W Poly Webb Rd
Arlington, TX 76016-3615

Mailing address

6702 W Poly Webb Rd
Arlington, TX 76016-3615

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000987 TX Practitioner - Physical Therapist in Private Practice 2264490937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Terry M Robinson Jr LPT Inc.Group PAC ID 2163324880, 2 clinicians

Practice addresses (Care Compare)

204 N Dooley St
Suite 300
Grapevine, TX 76051-9207
Phone (817) 481-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Terry M Robinson Jr LPT Inc. Physical Therapist CurrentSince Jul 1, 2018 Accepting new patients
Lake Arlington Holding Company Past Accepting new patients

Locations

204 N Dooley St
Ste 300
Grapevine, TX 76051
Phone (817) 251-9790

Organizations & group practices 2

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1750415907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6702 W POLY WEBB RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760163615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6702 W POLY WEBB RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760163615",
            "telephone_number": "817-478-0095",
            "fax_number": "817-478-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARD",
        "first_name": "JAMES",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1144624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.