NPIMap

Organization Active NPI

Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Trussville, AL
National Provider Identifier
1003842352
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SELECT PHYSICAL THERAPY HOLDINGS INC
Practice address
4735 Norrel Dr
Ste 3
Trussville, AL 35173
Phone
(205) 655-1620
Fax
(705) 655-0574
NPI assigned
Jun 25, 2006
Reactivated
Dec 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Authorized official

Name
Michael E Tarvin
Title
Vice President
Phone
(717) 975-4503

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

4735 Norrel Dr
Ste 3
Trussville, AL 35173

Mailing address

4716 Old Gettysburg Rd
Mechanicsburg, PA 17055
Phone (717) 975-4503

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171206001166 DC Part B Supplier - Clinic/Group Practice 9537076401 Receives reassigned benefits from 6 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silver Spring, MD

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Esop Rehabilitation LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4735 Norrel Dr
Ste 3
Trussville, AL 35173
Phone (205) 655-1620

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1003842352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17055",
            "telephone_number": "717-975-4503",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 NORREL DR",
            "address_2": "STE 3",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "35173",
            "telephone_number": "205-655-1620",
            "fax_number": "705-655-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT PHYSICAL THERAPY HOLDINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-12-13",
        "deactivation_date": "2007-10-29",
        "reactivation_date": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-975-4503"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trussville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.