Active NPI
Anthony Stine
- Physical Therapy Assistant
- Tyler, TX
National Provider Identifier
1821705625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4795
- Practice address
- 100 E Ferguson St
Tyler, TX 75702-5759 - Phone
- (903) 509-2040
- NPI assigned
- Nov 1, 2022
- Last updated
- Nov 1, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4795 | AR | Primary |
Addresses
Primary practice location
100 E Ferguson St
Tyler, TX 75702-5759
Mailing address
1431 Greenway Dr Ste 500
Irving, TX 75038-2444
Phone (877) 688-2520
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4795 | AR | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Apple LLC | Current | Accepting new patients |
Locations
1431 Greenway Dr
Ste 500
Irving, TX 75038
Phone (214) 467-9787
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1821705625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 GREENWAY DR STE 500",
"city": "IRVING",
"state": "TX",
"postal_code": "750382444",
"telephone_number": "877-688-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E FERGUSON ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757025759",
"telephone_number": "903-509-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STINE",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-01",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "4795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.