Organization Active NPI

Professional Physical Therapy, PC

  • Physical Therapist
  • Danville, IL
National Provider Identifier
1083611008
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
060-007809 Issued in IL
Legal business name
PROFESSIONAL PHYSICAL THERAPY, PC
Practice address
3815 N Vermilion St
Danville, IL 61832-1159
Phone
(217) 446-7878
Fax
(217) 446-7865
NPI assigned
Jul 5, 2005
Last updated
Jul 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Authorized official

Name
Ronnie L Day, PTNPI 1003001249
Title
PT/ Owner
Phone
(217) 446-7878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 060-007809 IL Primary

Addresses

Primary practice location

3815 N Vermilion St
Danville, IL 61832-1159

Mailing address

3815 N Vermilion St
Danville, IL 61832-1159
Phone (217) 446-7878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208000274 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9537110549 Receives reassigned benefits from 2 practitioners
Practice locations: Danville, IL

National Provider Directory

National Provider Directory
Tax ID family
Professional Physical Therapy PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3815 N Vermilion St
Danville, IL 61832
Phone (217) 446-7878

Practitioners & affiliated clinicians

Practitioners 3

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": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1083611008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321159",
            "telephone_number": "217-446-7878",
            "fax_number": "217-446-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321159",
            "telephone_number": "217-446-7878",
            "fax_number": "217-446-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "DAY",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PT/ OWNER",
        "authorized_official_telephone_number": "217-446-7878",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "060-007809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.