Individual provider Active NPI

Nicole Rodman, PT

  • Physical Therapist
  • Grapevine, TX
National Provider Identifier
1861680324
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1177273 Issued in TX
Practice address
1643 Lancaster Dr Ste 100
Grapevine, TX 76051-3593
Phone
(817) 329-2524
NPI assigned
Oct 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1177273 TX Primary

Addresses

Primary practice location

1643 Lancaster Dr Ste 100
Grapevine, TX 76051-3593

Mailing address

1643 Lancaster Dr Ste 100
Grapevine, TX 76051-3593
Phone (817) 329-2524

Other identifiers 1

IdentifierTypeStateIssuer
1177273OtherTXLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091019000569 TX Practitioner - Physical Therapist in Private Practice 9234276544 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Texas Limited PartnershipGroup PAC ID 6608868070, 91 clinicians

Practice addresses (Care Compare)

5311 N Loop 1604
Suite 104
San Antonio, TX 78249-4392
Phone (726) 227-9610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Texas Limited Partnership CurrentSince Feb 4, 2025 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist CurrentSince Feb 4, 2025 Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jan 24, 2025 Accepting new patients
Dallas Nephrology Associates PastSince Jan 26, 2025 Accepting new patients
Bir JV LLP PastSince Jan 26, 2025 Accepting new patients

Locations

4899 Highway 6
Ste 212C
Missouri City, TX 77459
Phone (346) 371-2121

5311 N Loop 1604 W
Ste 104
San Antonio, TX 78249
Phone (726) 227-9610

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

Interoperability endpoints

  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1861680324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 LANCASTER DR STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513593",
            "telephone_number": "817-329-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 LANCASTER DR STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513593",
            "telephone_number": "817-329-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODMAN",
        "first_name": "NICOLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1177273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1177273",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.