NPIMap

Organization Active NPI

Symmetry Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • Austin, TX
National Provider Identifier
1760733711
Registry record updated Sep 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1116903 Issued in TX
Legal business name
SYMMETRY PHYSICAL THERAPY, LLC
Practice address
2200 Park Bend Dr
Building 1, Suite 202
Austin, TX 78758-5387
Phone
(512) 339-1500
Fax
(512) 339-1501
NPI assigned
Sep 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2012

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

Authorized official

Name
Julie Michelle Mankinen, PTNPI 1649380999
Title
Physical Therapist / Owner
Phone
(512) 452-2667

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 1116903 TX Primary

Addresses

Primary practice location

2200 Park Bend Dr
Building 1, Suite 202
Austin, TX 78758-5387

Mailing address

2200 Park Bend Dr
Building 1, Suite 202
Austin, TX 78758-5387
Phone (512) 339-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121031000012 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6507016466 Receives reassigned benefits from 7 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

2217 Park Bend Dr
Ste 240
Austin, TX 78758
Phone (512) 339-1500

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348876800000",
    "number": "1760733711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "BUILDING 1, SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-339-1500",
            "fax_number": "512-339-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "BUILDING 1, SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-339-1500",
            "fax_number": "512-339-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYMMETRY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-29",
        "last_updated": "2012-09-29",
        "status": "A",
        "authorized_official_last_name": "MANKINEN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "512-452-2667",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1116903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2012; 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.