NPIMap

Organization Active NPI

Pro PT, Inc.

  • Physical Therapist
  • Brookings, SD
National Provider Identifier
1053414235
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRO PT, INC.
Practice address
302 W 6TH St
Brookings, SD 57006-1159
Phone
(605) 692-8848
Fax
(605) 692-8849
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Mrs. Lisa Johnson
Title
Business Manager
Phone
(605) 692-8848

Specialties & licenses 1

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

Addresses

Primary practice location

302 W 6TH St
Brookings, SD 57006-1159

Mailing address

302 W 6TH St
Brookings, SD 57006-1159
Phone (605) 692-8848

Other identifiers 1

IdentifierTypeStateIssuer
DF4108OtherRAILROAD MEDICARE

Other names 1

  • Professionals in Physical Therapy Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000018 SD Part B Supplier - Clinic/Group Practice 8325139041 Receives reassigned benefits from 5 practitioners
Practice locations: Brookings, SD

National Provider Directory

National Provider Directory

Locations

302 W 6th St
Brookings, SD 57006
Phone (605) 203-3198

1552 Dakota Ave S
Huron, SD 57350
Phone (605) 352-9498

Practitioners & affiliated clinicians

Practitioners 10

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": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1053414235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W 6TH ST",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061159",
            "telephone_number": "605-692-8848",
            "fax_number": "605-692-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W 6TH ST",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061159",
            "telephone_number": "605-692-8848",
            "fax_number": "605-692-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO PT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "605-692-8848",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF4108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professionals in Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Professionals in Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brookings, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.