Active NPI
Robert Freeman Fewkes, PT, DPT, MOTR/L
- Physical Rehabilitation Occupational Therapist
- Fort Sam Houston, TX
National Provider Identifier
1922519545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 117009
- Practice address
- 3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504 - Phone
- (801) 556-6298
- NPI assigned
- Oct 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1279000 | TX | |
| Pediatric Occupational Therapist | 225XP0200X | 117009 | TX | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 117009 | TX | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1279000 | TX | MD | Pediatric Physical Therapist |
| 117009 | TX | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1922519545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "801-556-6298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEWKES",
"first_name": "ROBERT",
"middle_name": "FREEMAN",
"credential": "PT, DPT, MOTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-23",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "TX",
"license": "1279000",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "117009",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "TX",
"license": "117009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.