NPIMap

Organization Active NPI

Ozark Physical Medicine Center for Operations Ozark Plaza and Medical

  • Physical Therapy Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1053821322
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
OZARK PHYSICAL MEDICINE CENTER FOR OPERATIONS OZARK PLAZA AND MEDICAL
Practice address
2725 N Westwood Blvd Ste 17
Poplar Bluff, MO 63901-2367
Phone
(573) 778-9348
NPI assigned
Oct 2, 2017
Last updated
Nov 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Authorized official

Name
Ashley Tinsley
Title
Owner
Phone
(573) 686-5510

Specialties & licenses 1

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

Addresses

Primary practice location

2725 N Westwood Blvd Ste 17
Poplar Bluff, MO 63901-2367

Mailing address

2725 N Westwood Blvd Ste 17
Poplar Bluff, MO 63901-2367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171120002504 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8527349422 Receives reassigned benefits from 4 practitioners
Practice locations: Poplar Bluff, MO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ozark Physical Ctr Medical3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1053821322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 N WESTWOOD BLVD STE 17",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 N WESTWOOD BLVD STE 17",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012367",
            "telephone_number": "573-778-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK PHYSICAL MEDICINE CENTER FOR OPERATIONS OZARK PLAZA AND MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "TINSLEY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-686-5510"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.