NPIMap

Organization Active NPI

Proactive Physical Therapy Centers, PLLC

  • Physical Therapist
  • Pearland, TX
National Provider Identifier
1851454326
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROACTIVE PHYSICAL THERAPY CENTERS, PLLC
Practice address
10223 W Broadway
Suite B
Pearland, TX 77584-7881
Phone
(713) 436-3900
Fax
(713) 436-3904
NPI assigned
Dec 18, 2006
Last updated
Mar 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Keith Stewart Blasingame, PTNPI 1447350236
Title
Owner/Ceo
Phone
(713) 436-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

10223 W Broadway
Suite B
Pearland, TX 77584-7881

Mailing address

10223 Broadway St
Suite B
Pearland, TX 77584-7880
Phone (713) 436-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060202000940 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022926492 Receives reassigned benefits from 19 practitioners
Practice locations: Pearland, TX; Webster, TX; Shenandoah, TX; Pasadena, TX

National Provider Directory

National Provider Directory

Locations

10575 Katy Fwy
Ste 244
Houston, TX 77024
Phone (832) 657-0900

4600 Fairmont Pkwy
Ste 205
Pasadena, TX 77504
Phone (281) 998-8600

10223 Broadway St
Pearland, TX 77584
Phone (646) 541-1016

10223 Broadway St
Ste B
Pearland, TX 77584
Phone (713) 436-3900

8850 Six Pines Dr
Ste 290
Shenandoah, TX 77380
Phone (281) 364-8844

250 Blossom St
Ste 240
Webster, TX 77598
Phone (281) 724-0300

251 W Medical Center Blvd
Ste 240
Webster, TX 77598
Phone (281) 724-0300

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1851454326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 BROADWAY ST",
            "address_2": "SUITE B",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847880",
            "telephone_number": "713-436-3900",
            "fax_number": "713-436-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10223 W BROADWAY",
            "address_2": "SUITE B",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847881",
            "telephone_number": "713-436-3900",
            "fax_number": "713-436-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY CENTERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "BLASINGAME",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "713-436-3900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.