Individual provider Active NPI

Sammy Wayne Dennard, P.T.

  • Physical Therapist
  • Big Spring, TX
National Provider Identifier
1780786962
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1063691 Issued in TX
Practice address
300 W Veterans Blvd
Big Spring, TX 79720-5566
Phone
(432) 263-7361
Fax
(432) 268-5048
NPI assigned
Sep 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1063691 TX Primary

Addresses

Primary practice location

300 W Veterans Blvd
Big Spring, TX 79720-5566

Mailing address

6 Glenwick CV
Big Spring, TX 79720-6603
Phone (432) 267-5459

Other identifiers 1

IdentifierTypeStateIssuer
1063691OtherTXPHYSICAL THERAPY LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1063691TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780786962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GLENWICK CV",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797206603",
            "telephone_number": "432-267-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W VETERANS BLVD",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797205566",
            "telephone_number": "432-263-7361",
            "fax_number": "432-268-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNARD",
        "first_name": "SAMMY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1063691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "1063691",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.