Individual provider Active NPI

Stevan Autrey Duke, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1861709107
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1199468 Issued in TX
Practice address
12457 Timberland Blvd Ste 205
Fort Worth, TX 76244-5211
Phone
(682) 213-3006
Fax
(682) 316-6643
NPI assigned
Sep 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 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 1199468 TX Primary

Addresses

Primary practice location

12457 Timberland Blvd Ste 205
Fort Worth, TX 76244-5211

Mailing address

5100 Eldorado Pkwy
McKinney, TX 75070-6510
Phone (972) 401-0300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000809 TX Practitioner - Physical Therapist in Private Practice 8820273840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportherapy LLCGroup PAC ID 0749536308, 45 clinicians

Practice addresses (Care Compare)

12457 Timberland Blvd
Suite 205
Fort Worth, TX 76244-5211
Phone (682) 213-3006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportherapy LLC Physical Therapist CurrentSince May 26, 2020 Accepting new patients
Sportherapy Southwest, PC Physical Therapist Past Accepting new patients

Locations

12457 Timberland Blvd
Ste 205
Fort Worth, TX 76244
Phone (682) 213-3006

4108 Boat Club Rd
Lake Worth, TX 76135
Phone (817) 238-9295

965 Hilltop Dr
Weatherford, TX 76086
Phone (817) 370-9891

Organizations & group practices 2

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": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1861709107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 ELDORADO PKWY",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750706510",
            "telephone_number": "972-401-0300",
            "fax_number": "972-401-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12457 TIMBERLAND BLVD STE 205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445211",
            "telephone_number": "682-213-3006",
            "fax_number": "682-316-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "STEVAN",
        "middle_name": "AUTREY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1199468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.