NPIMap

Organization Active NPI

Serc Rehabilitation Partners LLC

Doing business as SERC - Sedalia, MO

  • Physical Therapy Clinic/Center
  • Sedalia, MO
National Provider Identifier
1013469105
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SERC REHABILITATION PARTNERS LLC
Doing business as
SERC - Sedalia, MO
Practice address
115 W Broadway Blvd
Ste 300
Sedalia, MO 65301-5708
Phone
(660) 827-2945
Fax
(660) 827-2961
NPI assigned
Oct 25, 2016
Last updated
Oct 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle Operations
Phone
(423) 238-7217

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X MO
Physical Therapy Clinic/Center 261QP2000X MO Primary
Occupational Medicine Clinic/Center 261QX0100X MO

Addresses

Primary practice location

115 W Broadway Blvd
Ste 300
Sedalia, MO 65301-5708

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other names 1

  • SERC - Sedalia, MO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Serc Rebabilitation Partners LLC82 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1013469105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W BROADWAY BLVD",
            "address_2": "STE 300",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015708",
            "telephone_number": "660-827-2945",
            "fax_number": "660-827-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERC REHABILITATION PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERC - Sedalia, MO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedalia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.