Lake Fork Physical Therapy, PLLC
NPI 1154540540 · Physical Therapist · Emory, TX
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Fork Physical Therapy, PLLC is a Physical Therapist organization in Emory, TX (NPI 1154540540).
Provider details
- NPI number
- 1154540540
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Paul Bacon, Licensed Physical Therapist(903) 474-9436
- License
- 1124006 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-04-24
- Last updated
- 2014-07-08
Frequently asked questions
- What is Lake Fork Physical Therapy, PLLC's NPI number?
- Lake Fork Physical Therapy, PLLC's National Provider Identifier (NPI) is 1154540540, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Fork Physical Therapy, PLLC?
- Lake Fork Physical Therapy, PLLC is classified in the NPPES registry as Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Lake Fork Physical Therapy, PLLC located?
- Lake Fork Physical Therapy, PLLC's practice location on file with NPPES is 903 East Lennon Street, Emory, TX 75440.
- What is Lake Fork Physical Therapy, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Fork Physical Therapy, PLLC is (903) 474-9436.
- Does Lake Fork Physical Therapy, PLLC accept Medicare?
- Lake Fork Physical Therapy, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Fork Physical Therapy, PLLC?
- The authorized official listed on Lake Fork Physical Therapy, PLLC's NPPES record is Paul Bacon, Licensed Physical Therapist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Fork Physical Therapy, PLLC's NPI active?
- Yes — Lake Fork Physical Therapy, PLLC's NPI (1154540540) is active in the NPPES registry as of the last update on 2014-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.