NPIMap

Organization Active NPI

SN Kentuckiana Rehab, LLC

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
National Provider Identifier
1063978435
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SN KENTUCKIANA REHAB, LLC
Practice address
2152 S Hurstbourne Pkwy
Louisville, KY 40220-1622
Phone
(502) 499-0107
Fax
(502) 499-0535
NPI assigned
Feb 11, 2019
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Authorized official

Name
Michael Tarvin
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2152 S Hurstbourne Pkwy
Louisville, KY 40220-1622

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Other names 1

  • KORT 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
O20190501002824 KY DME Supplier - Independently-Practicing Physical Therapist 1254671464 Practice locations: Louisville, KY

Other NPIs with the same Medicare PAC ID 18

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

View all 18

National Provider Directory

National Provider Directory
Tax ID family
SN Kentuckiana Rehab LLC43 organizations share this tax ID, including this one
Part of
Select Medical Corporation

Other organizations with this tax ID 42

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

View all 42

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1063978435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 S HURSTBOURNE PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201622",
            "telephone_number": "502-499-0107",
            "fax_number": "502-499-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SN KENTUCKIANA REHAB, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KORT Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.