NPIMap

Organization Active NPI

Champion Rehab Resources, LLC

  • Physical Therapist
  • Vestavia, AL
National Provider Identifier
1003437906
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CHAMPION REHAB RESOURCES, LLC
Practice address
451 Liberty Pkwy
Vestavia, AL 35242-7666
Phone
(256) 543-1030
NPI assigned
May 1, 2020
Last updated
May 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Authorized official

Name
Michael Bolton
Title
Customer and Employee Relations
Phone
(256) 543-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

451 Liberty Pkwy
Vestavia, AL 35242-7666

Mailing address

1514 Owens St
Gadsden, AL 35904-4938
Phone (256) 543-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200612002194 AL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385066752 Receives reassigned benefits from 1 practitioner
Practice locations: Gadsden, AL

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hanceville Nursing & Rehab Center Inc.Hanceville, AL, CCN 015073 Skilled nursing facility Adp of the SNF Jan 1, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1003437906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 OWENS ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359044938",
            "telephone_number": "256-543-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LIBERTY PKWY",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352427666",
            "telephone_number": "256-543-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION REHAB RESOURCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CUSTOMER AND EMPLOYEE RELATIONS",
        "authorized_official_telephone_number": "256-543-1030"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia, AL

Sources for this page

Verify at the official NPI Registry.