Individual provider Active NPI

Nic Espanet

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1982220950
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1105716 Issued in TX
Practice address
2550 Boyd Ave
Fort Worth, TX 76109-1021
Phone
(817) 480-3798
NPI assigned
Jun 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 1105716 TX Primary

Addresses

Primary practice location

2550 Boyd Ave
Fort Worth, TX 76109-1021

Mailing address

PO Box 100991
Fort Worth, TX 76185-0991
Phone (817) 480-3798

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL webPT Something Amazing Home Therapy, LLC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1105716TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1982220950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100991",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761850991",
            "telephone_number": "817-480-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 BOYD AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091021",
            "telephone_number": "817-480-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPANET",
        "first_name": "NIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1105716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "webPT",
            "affiliation": "Y",
            "endpointDescription": "emr",
            "affiliationName": "Something Amazing Home Therapy, LLC",
            "address_1": "2550 Boyd Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761091021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 27, 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.