Transformation Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TRANSFORMATION PHYSICAL THERAPY LLC

Practice address

275 S. Denton Tap Rd.
Ste. 150
Coppell, TX 75019

Phone

(214) 864-2440

NPI assigned

Nov 3, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Sullivan Bullock, D.P.T.NPI 1164907986

Title

Owner

Phone

(214) 864-2440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Sullivan Bullock, PT, DPT

  • Physical Therapist
  • Mountain Village, CO
  • NPI 1164907986

  TX

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1992460174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S. DENTON TAP RD.",
            "address_2": "STE. 150",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "214-864-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S. DENTON TAP RD.",
            "address_2": "STE. 150",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "214-864-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "SULLIVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-864-2440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mary Jo Treadway, RPH
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• Cindy Truong
• Kiet Tuan Truong, M.D.
• Hadley Arden Turner, MSOTR/L

• Physical Therapist in Coppell, TX
• Providers in Coppell, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.