NPIMap

Organization Active NPI

Winfrey Enterprises, LLC

Doing business as Canyon Physical Therapy

  • Physical Therapist
  • Canyon, TX
National Provider Identifier
1902135973
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1139046 Issued in TX
Legal business name
WINFREY ENTERPRISES, LLC
Doing business as
Canyon Physical Therapy
Practice address
907 23Rd St
Canyon, TX 79015-4645
Phone
(806) 655-6824
Fax
(806) 655-6823
NPI assigned
Dec 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Authorized official

Name
Jennifer M Winfrey, PTNPI 1952317471
Title
PT/Owner
Phone
(806) 655-6824

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1139046 TX Primary

Addresses

Primary practice location

907 23Rd St
Canyon, TX 79015-4645

Mailing address

907 23Rd St
Canyon, TX 79015-4645
Phone (806) 655-6824

Other names 1

  • Canyon Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100327000580 TX Part B Supplier - Clinic/Group Practice 8729114806 Receives reassigned benefits from 5 practitioners
Practice locations: Canyon, TX

National Provider Directory

National Provider Directory

Locations

907 23rd St
Canyon, TX 79015
Phone (806) 655-6823

Practitioners & affiliated clinicians

Practitioners 7

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": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1902135973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 23RD ST",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154645",
            "telephone_number": "806-655-6824",
            "fax_number": "806-655-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 23RD ST",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154645",
            "telephone_number": "806-655-6824",
            "fax_number": "806-655-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINFREY ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "WINFREY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "806-655-6824",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1139046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canyon, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.