Individual provider Active NPI

Krista M Faulkner, PT, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1780338772
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5500 Overton Ridge Blvd Ste 228
Fort Worth, TX 76132-3281
Phone
(817) 259-1255
Fax
(817) 764-9008
NPI assigned
Feb 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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 Primary

Addresses

Primary practice location

5500 Overton Ridge Blvd Ste 228
Fort Worth, TX 76132-3281

Mailing address

10152 Wandering Way St
Benbrook, TX 76126-3012
Phone (817) 455-5455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220506001136 TX Practitioner - Physical Therapist in Private Practice 2769869098 Reassigns benefits to 1 organization
I20240926004317 CA Practitioner - Physical Therapist in Private Practice 2769869098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Function for Life Physical Therapy IncGroup PAC ID 3678758489, 36 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

2719 Loker Ave W
Suite a
Carlsbad, CA 92010-6679
Phone (760) 918-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Function for Life Physical Therapy, Inc. Physical Therapist CurrentSince Sep 17, 2024 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Sep 25, 2025 Accepting new patients
Ratner Center for Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Feb 15, 2022 Accepting new patients
Sportherapy LLC Physical Therapist PastSince Feb 13, 2022 Accepting new patients

Locations

2719 Loker Ave W
Ste A
Carlsbad, CA 92010
Phone (760) 918-9200

3257 Camino de los Coches
Ste 301
Carlsbad, CA 92009
Phone (760) 652-5236

1084 N El Camino Real
#B351
Encinitas, CA 92024

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

5500 Overton Ridge Blvd
Ste 228
Ft Worth, TX 76132
Phone (817) 259-1255

Organizations & group practices 4

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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1780338772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10152 WANDERING WAY ST",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761263012",
            "telephone_number": "817-455-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 OVERTON RIDGE BLVD STE 228",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323281",
            "telephone_number": "817-259-1255",
            "fax_number": "817-764-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "KRISTA",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.