Active NPI
Joe Petree, PTA
- Physical Therapy Assistant
- Cisco, TX
National Provider Identifier
1831649433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2114207
- Practice address
- 200 W 8TH St
Cisco, TX 76437-3023 - Phone
- (254) 631-7503
- NPI assigned
- Oct 6, 2016
- Last updated
- Oct 6, 2016
- 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 | 2114207 | TX | Primary |
Addresses
Primary practice location
200 W 8TH St
Cisco, TX 76437-3023
Mailing address
200 W 8TH St
Cisco, TX 76437-3023
Phone (254) 631-7503
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2114207 | TX | MD | Physical Therapy Assistant |
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.
-
dba Pivot Physical Therapy
- Physical Therapy Clinic/Center
- Cisco, TX
- NPI 1265989271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1831649433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W 8TH ST",
"city": "CISCO",
"state": "TX",
"postal_code": "764373023",
"telephone_number": "254-631-7503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W 8TH ST",
"city": "CISCO",
"state": "TX",
"postal_code": "764373023",
"telephone_number": "254-631-7503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETREE",
"first_name": "JOE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-06",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2114207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cisco, TX
- Nicole Marie Mark, LMSW
- Ashley McKee, LMFT ASSOCIATE
- Laura Diane Miller, LVN
- Keali Mullins
- Petree and Hearne Therapy Enterprises, PLLC (Pivot Physical Therapy)
- Rhonda Lynne Pipkin, LPC, MA, PSYD
- Plexus Medical Supply, LLC
- Plexus Treatment Centers, P.a. (Plexus Healthcare Center)
- Pyramid Healthcare Corp. (Canterbury Villa of Cisco)
- Jonathon Heath Reich, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.