Impact Physical Therapy, L.L.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1056786 Issued in TX

Legal business name

IMPACT PHYSICAL THERAPY, L.L.C.

Practice address

100 N. Hwy 77
Suite N
Raymondville, TX 78580-4010

Phone

(956) 689-9195

Fax

(956) 659-9217

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Shawn Spanihel, P.T.

Title

Owner

Phone

(956) 689-9195

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334620800000",
    "number": "1861556508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N. HWY 77",
            "address_2": "SUITE N",
            "city": "RAYMONDVILLE",
            "state": "TX",
            "postal_code": "785804010",
            "telephone_number": "956-689-9195",
            "fax_number": "956-659-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N. HWY 77",
            "address_2": "SUITE N",
            "city": "RAYMONDVILLE",
            "state": "TX",
            "postal_code": "785804010",
            "telephone_number": "956-689-9195",
            "fax_number": "956-659-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICAL THERAPY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2012-04-17",
        "status": "A",
        "authorized_official_last_name": "SPANIHEL",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-689-9195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "1056786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR HEALTHPLAN",
            "identifier": "116160",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "659445",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021737402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021737401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107970903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Raymondville, TX
• Providers in Raymondville, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.