Active NPI
Monet Supple, DPT
- Physical Therapist
- Lubbock, TX
National Provider Identifier
1780139121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4859
- Practice address
- 8214 Milwaukee Ave
Lubbock, TX 79424-0923 - Phone
- (806) 795-6421
- Fax
- (806) 795-1528
- NPI assigned
- Aug 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4859 | NM | Primary |
Addresses
Primary practice location
8214 Milwaukee Ave
Lubbock, TX 79424-0923
Mailing address
8214 Milwaukee Ave
Lubbock, TX 79424-0923
Phone (806) 795-6421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4859 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1780139121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8214 MILWAUKEE AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794240923",
"telephone_number": "806-795-6421",
"fax_number": "806-795-1528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8214 MILWAUKEE AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794240923",
"telephone_number": "806-795-6421",
"fax_number": "806-795-1528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPPLE",
"first_name": "MONET",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "4859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.