Individual provider Active NPI

Rebecca Lyn Snell, PHYSICAL THERAPIST

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1922194588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1114197 Issued in TX
Practice address
4255 Amon Carter Blvd.
Fort Worth, TX 76155
Phone
(817) 963-1200
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1114197 TX Primary

Addresses

Primary practice location

4255 Amon Carter Blvd.
Fort Worth, TX 76155

Mailing address

3918 Keller Hicks Road
Keller, TX 76248-9622
Phone (817) 688-7345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1114197TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922194588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3918 KELLER HICKS ROAD",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762489622",
            "telephone_number": "817-688-7345",
            "fax_number": "817-337-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 AMON CARTER BLVD.",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76155",
            "telephone_number": "817-963-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELL",
        "first_name": "REBECCA",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1114197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.