NPIMap

Organization Active NPI

Complete Hometown Physical Therapy, LLC

  • Physical Therapist
  • Hallettsville, TX
National Provider Identifier
1891039632
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COMPLETE HOMETOWN PHYSICAL THERAPY, LLC
Practice address
203 N Main St
Hallettsville, TX 77964-2729
Phone
(512) 393-4100
Fax
(361) 238-5000
NPI assigned
Nov 16, 2012
Last updated
Jun 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Authorized official

Name
Mrs. Kelly Deann Chance, PTNPI 1144556325
Title
Owner/PT
Phone
(512) 393-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

203 N Main St
Hallettsville, TX 77964-2729

Mailing address

PO Box 248
Hallettsville, TX 77964-0248
Phone (512) 743-1580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130321000252 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890930853 Receives reassigned benefits from 8 practitioners
Practice locations: Cuero, TX; Hallettsville, TX; Shiner, TX; Yoakum, TX

National Provider Directory

National Provider Directory

Locations

607 S Esplanade St
Ste 4
Cuero, TX 77954
Phone (361) 418-0033

203 N Main St
Hallettsville, TX 77964
Phone (361) 798-3500

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1891039632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779640248",
            "telephone_number": "512-743-1580",
            "fax_number": "361-238-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779642729",
            "telephone_number": "512-393-4100",
            "fax_number": "361-238-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE HOMETOWN PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "CHANCE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DEANN",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "512-393-4100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallettsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.