Active NPI
Thaddeus Stephenson Jr., RKT
- Kinesiotherapist
- Longview, TX
National Provider Identifier
1811862600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- License
- 1991
- Practice address
- 1005 N Eastman Rd
Longview, TX 75601-4231 - Phone
- (903) 248-3450
- NPI assigned
- Oct 9, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | 1991 | Primary |
Addresses
Primary practice location
1005 N Eastman Rd
Longview, TX 75601-4231
Mailing address
1005 N Eastman Rd
Longview, TX 75601-4231
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759968000000",
"number": "1811862600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 N EASTMAN RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756014231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 N EASTMAN RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756014231",
"telephone_number": "903-248-3450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENSON",
"first_name": "THADDEUS",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RKT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-09",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": null,
"license": "1991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.