Ignite Performance Center and Sports Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

IGNITE PERFORMANCE CENTER AND SPORTS REHAB LLC

Practice address

313 Main Street
Velma, OK 73491-9998

Phone

(409) 392-7628

NPI assigned

Mar 24, 2015

Last updated

Mar 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. George Eddie Dewbre

Title

Owner/Manager

Phone

(409) 392-7628

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1053705541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "VELMA",
            "state": "OK",
            "postal_code": "734910298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MAIN STREET",
            "city": "VELMA",
            "state": "OK",
            "postal_code": "734919998",
            "telephone_number": "409-392-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE PERFORMANCE CENTER AND SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "DEWBRE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDDIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "409-392-7628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duncan Regional Hospital, Inc. (d/b/a Jefferson County Hospital d/b/a Velma Family Care)
• Lauren Virginia Duroy, DNP, APRN, FNP-C
• Town of Velma (DBA: Velma Community Ambulance)
• Michelle Christine Vannoy, APRN

• Physical Therapist in Velma, OK
• Providers in Velma, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.