Advanced PT, LLC
Organization Active NPI Physical Therapy Clinic/Center · Wichita, KS
NPI 1053906404 · NPPES record last updated Mar 12, 2021
Key facts
- NPI
- 1053906404
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- ADVANCED PT, LLC
- Practice address
- 4515 E Central Ave Ste a
Wichita, KS 67208-3915 - Phone
- (316) 260-6869
- Fax
- (316) 260-6872
- NPI assigned
- Mar 8, 2021
- Organization subpart
- No
Authorized official
- Name
- David Charles Todd
- Title
- Ceo
- Phone
- (316) 263-0003
Other NPIs on the same Medicare enrollment 27
Corporate family (same tax ID) 22
Practitioners 6
-
Taylor Hoang, PT, DPT
-
Catelin Infante Kass, PT, DPT
-
Jennifer Ann Pina, DPT
-
Michaela Renee Toews, DPT
-
Madison Walls, DPT
-
Jason Tejano, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060222000723 | KS | Part B Supplier - Clinic/Group Practice | 3678524709 |
Receives reassigned benefits from 102 practitioners 27 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Arkansas City, KS; Andover, KS; Winfield, KS; Wichita, KS; Wellington, KS; Sterling, KS; Park City, KS; Newton, KS… |
National Provider Directory
- Tax ID family
- Preferred PT Nampa
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
4515 E Central Ave Ste a
Wichita, KS 67208-3915
Mailing address
200 W Douglas Ave Ste 250
Wichita, KS 67202-3002
Phone (316) 263-0003
Other names
- Advanced PT College HIl
Other providers in Wichita, KS
- Advanced PT LLC
- Advanced PT LLC
- Advanced PT McLean LLC
- Advanced PT Pca, LLC
- Advanced PT, LLC
- Advanced PT, LLC
- Advanced PT, LLC
- Advanced PT, LLC
- Advanced PT, LLC
- Advanced PT, LLC
All providers in Wichita, KS · Physical Therapy Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.