Individual provider Active NPI

Marie Louise Kidd

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1891364501
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
21 Spurs LN Ste 340
San Antonio, TX 78240-1680
Phone
(210) 798-8585
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 Primary

Addresses

Primary practice location

21 Spurs LN Ste 340
San Antonio, TX 78240-1680

Mailing address

7505 N Loop 1604 E Ste 101
Live Oak, TX 78233-2604
Phone (210) 590-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210625000243 TX Practitioner - Physical Therapist in Private Practice 0840691044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Medicine Associates of San Antonio PAGroup PAC ID 3274525548, 55 clinicians

Practice addresses (Care Compare)

21 Spurs LN
Suite 340
San Antonio, TX 78240-1680
Phone (210) 798-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine Associates of San Antonio, PA CurrentSince May 28, 2021 Accepting new patients
Sports Medicine Associates of San Antonio, PA Physical Therapist CurrentSince May 28, 2021 Accepting new patients
Texas Physical Therapy Specialists CurrentSince May 28, 2021 Accepting new patients
Texas Physical Therapy Specialists, Inc. Physical Therapist CurrentSince May 28, 2021 Accepting new patients
Sports Medicine Associates of San Antonio, PA Physical Therapist Past Accepting new patients

Locations

11150 Research Blvd
Ste 212
Austin, TX 78759
Phone (512) 794-8863

112 Herff Rd
Ste 310
Boerne, TX 78006
Phone (830) 431-9660

11909 Preston Rd
Ste 1482
Dallas, TX 75230
Phone (214) 446-1601

1789 S Bagdad Rd
Ste 102
Leander, TX 78641
Phone (512) 337-8970

12500 Judson Rd
Ste 201
Live Oak, TX 78233
Phone (210) 314-1071

7505 N Loop 1604 E
Ste 101
Live Oak, TX 78233
Phone (210) 590-4000

1324 E Common St
Ste 307
New Braunfels, TX 78130
Phone (830) 625-7310

12508 Jones Maltsberger Rd
Ste 110
San Antonio, TX 78247

21 Spurs Ln
Ste 340
San Antonio, TX 78240
Phone (210) 590-4000

430 W Sunset Rd
Ste 430
San Antonio, TX 78209
Phone (210) 253-3450

10622 State Highway 151
Ste 204
San Antonio, TX 78251
Phone (210) 798-8576

21 Spurs Ln
Ste 300
San Antonio, TX 78240
Phone (210) 561-7137

Organizations & group practices 5

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1891364501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 N LOOP 1604 E STE 101",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332604",
            "telephone_number": "210-590-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 340",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401680",
            "telephone_number": "210-798-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "MARIE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.