NPIMap

Organization Active NPI

Theraspecialists Inc

  • Physical Therapy Clinic/Center
  • Jasper, TX
National Provider Identifier
1891733838
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
THERASPECIALISTS INC
Practice address
296 Marvin Hancock Dr
Jasper, TX 75951-3479
Phone
(409) 384-7041
Fax
(409) 384-7064
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Cary G Malone, PT DPTNPI 1033159926
Title
President
Phone
(409) 384-7041

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

296 Marvin Hancock Dr
Jasper, TX 75951-3479

Mailing address

296 Marvin Hancock Dr
Jasper, TX 75951-3479
Phone (409) 384-7041

Other identifiers 1

IdentifierTypeStateIssuer
30KXOtherTXBLUE CROSS & BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000623 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3072500123 Receives reassigned benefits from 4 practitioners
Practice locations: Jasper, TX

National Provider Directory

National Provider Directory

Locations

1009 Dickerson Dr
Jasper, TX 75951
Phone (409) 384-7041

296 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-7041

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1891733838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 MARVIN HANCOCK DR",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759513479",
            "telephone_number": "409-384-7041",
            "fax_number": "409-384-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 MARVIN HANCOCK DR",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759513479",
            "telephone_number": "409-384-7041",
            "fax_number": "409-384-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERASPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "CARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-384-7041",
        "authorized_official_credential": "PT DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "30KX",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.