Individual provider Active NPI

William Threadgill, PHYSICAL THERAPIST

  • Orthopedic Physical Therapist
  • Lubbock, TX
National Provider Identifier
1790848893
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1063576 Issued in TX
Practice address
4010 82ND St
Suite 130
Lubbock, TX 79423-1949
Phone
(806) 783-8234
Fax
(806) 783-8235
NPI assigned
Dec 19, 2006
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
Orthopedic Physical Therapist 2251X0800X 1063576 TX Primary

Addresses

Primary practice location

4010 82ND St
Suite 130
Lubbock, TX 79423-1949

Mailing address

5907 84TH St
Lubbock, TX 79424-3609
Phone (806) 783-8234

Other identifiers 1

IdentifierTypeStateIssuer
8T4088OtherTXBLUECROSSBLUESHIELD INDIV

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Audiology, PLLC Past Accepting new patients

Organizations & group practices 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790848893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5907 84TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243609",
            "telephone_number": "806-783-8234",
            "fax_number": "806-783-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 82ND ST",
            "address_2": "SUITE 130",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231949",
            "telephone_number": "806-783-8234",
            "fax_number": "806-783-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THREADGILL",
        "first_name": "WILLIAM",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1063576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD INDIV",
            "identifier": "8T4088",
            "state": "TX"
        }
    ],
    "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 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.