Kelly Lynette Dickerson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1168402 Issued in TX

Practice address

8700 N Tarrant Pkwy Ste 113
North Richland Hills, TX 76182-8464

Phone

(817) 498-8344

Fax

(817) 498-8702

NPI assigned

Oct 20, 2006

Last updated

Mar 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CPT Specialty Group LLC

  • Orthopedic Physical Therapist
  • Fort Worth, TX
  • NPI 1184009474
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1922180785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750198607",
            "telephone_number": "972-724-2400",
            "fax_number": "972-724-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 N TARRANT PKWY STE 113",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761828464",
            "telephone_number": "817-498-8344",
            "fax_number": "817-498-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "KELLY",
        "middle_name": "LYNETTE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1168402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Divine Opportunities (Home Instead)
• Thanh DO

• Physical Therapist in North Richland Hills, TX
• Providers in North Richland Hills, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.