NPIMap

Organization Active NPI

Summit Physical Therapy, PSC

  • Physical Therapist
  • Shelbyville, KY
National Provider Identifier
1023536778
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SUMMIT PHYSICAL THERAPY, PSC
Practice address
72 Mack Walters Rd
Shelbyville, KY 40065-1738
Phone
(502) 633-2443
Fax
(502) 633-3126
NPI assigned
Sep 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Debbie G Rothenburger
Title
Billing Manager
Phone
(502) 633-2443

Specialties & licenses 1

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

Addresses

Primary practice location

72 Mack Walters Rd
Shelbyville, KY 40065-1738

Mailing address

72 Mack Walters Rd
Shelbyville, KY 40065-1738
Phone (502) 633-2443

Other names 1

  • Shelbyville Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171002002974 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1355616319 Receives reassigned benefits from 3 practitioners
Practice locations: Shelbyville, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023536778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MACK WALTERS RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651738",
            "telephone_number": "502-633-2443",
            "fax_number": "502-633-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 MACK WALTERS RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651738",
            "telephone_number": "502-633-2443",
            "fax_number": "502-633-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROTHENBURGER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "502-633-2443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelbyville Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.