Individual provider Active NPI

Gary S Ward, PT

  • Physical Therapist
  • Odessa, TX
National Provider Identifier
1811082027
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1150746 Issued in TX
Practice address
2525 N Grandview Ave
Ste 400
Odessa, TX 79761-1600
Phone
(432) 550-4700
Fax
(432) 550-4715
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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 1150746 TX Primary

Addresses

Primary practice location

2525 N Grandview Ave
Ste 400
Odessa, TX 79761-1600

Mailing address

2525 N Grandview Ave
Ste 400
Odessa, TX 79761-1600
Phone (432) 550-4700

Other identifiers 1

IdentifierTypeStateIssuer
200395601MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070619000215 TX Practitioner - Physical Therapist in Private Practice 5092814939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phytex Rehabilitation, LLCGroup PAC ID 7012016959, 10 clinicians

Practice addresses (Care Compare)

1365 W University Blvd
Odessa, TX 79764-7121
Phone (432) 580-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1150746TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phytex Rehabilitation, LLC Physical Therapist CurrentSince Jul 31, 2006 Accepting new patients
Phytex Rehabilitation, LLC Physical Therapist Current Accepting new patients
Phytex Rehabilitation, LLC Physical Therapist CurrentSince Jul 31, 2006 Accepting new patients

Locations

1901 W Highway 90
Alpine, TX 79830
Phone (432) 837-5918

7036B FM 1960 Rd E
Humble, TX 77346
Phone (346) 241-0450

4409 W Wadley Ave
Midland, TX 79707
Phone (432) 617-3110

2525 N Grandview Ave
Ste 400
Odessa, TX 79761
Phone (432) 550-4700

5000 Hanover Dr
Odessa, TX 79761
Phone (432) 550-4700

1365 W University Blvd
Odessa, TX 79764
Phone (432) 580-0011

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nursex Home Health Services, LLCOdessa, TX, CCN 747783 Home health agency 5% Or Greater Direct Ownership Interest (46.5%)
Corporate Director
W-2 Managing Employee
Jan 1, 2019
Sep 12, 2014
Dec 15, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1811082027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 N GRANDVIEW AVE",
            "address_2": "STE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611600",
            "telephone_number": "432-550-4700",
            "fax_number": "432-550-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 N GRANDVIEW AVE",
            "address_2": "STE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611600",
            "telephone_number": "432-550-4700",
            "fax_number": "432-550-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "GARY",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1150746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200395601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.