NPIMap

Organization Active NPI

East Texas Pediatric Rehabilitation Associates Inc

Doing business as East Texas Children's Therapy Services

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Tyler, TX
National Provider Identifier
1871654244
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
EAST TEXAS PEDIATRIC REHABILITATION ASSOCIATES INC
Doing business as
East Texas Children's Therapy Services
East Texas Childrens Therapy Services
Practice address
5040 Kinsey Dr Ste 500
Tyler, TX 75703-3048
Phone
(903) 509-1313
Fax
(903) 509-1383
NPI assigned
Dec 12, 2006
Last updated
Jul 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Kristi Smith Currin, PT, PCS
Title
President, Owner
Phone
(903) 520-4803

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 651040000 TX
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

5040 Kinsey Dr Ste 500
Tyler, TX 75703-3048

Mailing address

5040 Kinsey Dr Ste 500
Tyler, TX 75703-3048
Phone (903) 509-1313

Other identifiers 1

IdentifierTypeStateIssuer
158966501MedicaidTX

Other names 2

  • EAST TEXAS CHILDREN'S THERAPY SERVICES Doing business as
  • East Texas Childrens Therapy Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030424000024 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7810806668 Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

1001 Wsw Loop 323
Tyler, TX 75701
Phone (430) 205-8710

1121 Ese 323 Loop
Ste 200
Tyler, TX 75701
Phone (903) 509-1313

5040 Kinsey Dr
Ste 500
Tyler, TX 75703
Phone (903) 509-1313

921 Shiloh Rd
Ste B100
Tyler, TX 75703
Phone (903) 509-1313

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1871654244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 KINSEY DR STE 500",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033048",
            "telephone_number": "903-509-1313",
            "fax_number": "903-509-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 KINSEY DR STE 500",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033048",
            "telephone_number": "903-509-1313",
            "fax_number": "903-509-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS PEDIATRIC REHABILITATION ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "SMITH CURRIN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "903-520-4803",
        "authorized_official_credential": "PT, PCS"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "651040000",
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158966501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST TEXAS CHILDREN'S THERAPY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Texas Childrens Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.