NPIMap

Organization Active NPI

SN Kentuckiana Rehab, LLC

Doing business as KORT Physical Therapy

  • Rehabilitation Clinic/Center
  • Louisville, KY
National Provider Identifier
1063985463
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SN KENTUCKIANA REHAB, LLC
Doing business as
KORT Physical Therapy
Practice address
210 E Gray St Ste 807
Louisville, KY 40202-3927
Phone
(502) 587-9350
Fax
(502) 587-9351
NPI assigned
Jan 8, 2019
Last updated
Jan 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 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
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

210 E Gray St Ste 807
Louisville, KY 40202-3927

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 KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190326002841 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254671464 Receives reassigned benefits from 215 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY; Mt Washington, KY; Shelbyville, KY; Shepherdsville, KY; Taylorsville, KY; La Grange, KY; Elizabethtown, KY; Crestwood, KY
O20190516001243 KY Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1254671464 1 other NPI on this enrollment
Practice locations: Louisville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063985463. Details of each certification follow.

  • CCN 186591 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 186591

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
KORT PHYSICAL THERAPY CENTER
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Oct 10, 2000
Last certification
Sep 18, 2019
Ownership / control type
Proprietary
Facility address
210 East Gray Street, Suite 807
Louisville, KY 40202

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

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

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

Locations

3509 S Hurstbourne Pkwy
Louisville, KY 40299
Phone (502) 537-7070

Practitioners & affiliated clinicians

Practitioners 7

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": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1063985463",
    "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": "210 E GRAY ST STE 807",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023927",
            "telephone_number": "502-587-9350",
            "fax_number": "502-587-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SN KENTUCKIANA REHAB, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "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": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "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

Verify at the official NPI Registry.