Mary Candace Hodge, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1065225 Issued in TX

Practice address

2308 Ridge Rd
Ste C
Rockwall, TX 75087-5154

Phone

(972) 772-3767

Fax

(972) 722-1868

NPI assigned

Jun 13, 2005

Reactivated

Mar 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1871597260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 RIDGE RD",
            "address_2": "STE C",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875154",
            "telephone_number": "972-772-3767",
            "fax_number": "972-722-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 RIDGE RD",
            "address_2": "STE C",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875154",
            "telephone_number": "972-772-3767",
            "fax_number": "972-722-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "MARY",
        "middle_name": "CANDACE",
        "name_prefix": "Miss",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-07-24",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1065225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "659527",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Julian Hines, PHARM.D
• Suzanne L Hittson, D.D.S.
• Makayla Ann Hix, LCSW
• Yingyan Ho, OD
• Leeann Hodge, OTR
• Hodges and Capps Orthodontics. PLLC
• Andrew Charles Hodges, DDS, MS.
• Jennifer Ann Hodges, LCSW
• Nathan E. Hodges, D.D.S., M.S., P.A.
• Katherina Anna Hofstetter

• Physical Therapist in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.