Idumange T. Idumange, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1965 Issued in AR

Practice address

505 W Pershing Blvd Ste D
N Little Rock, AR 72114-2157

Phone

(501) 812-4970

Fax

(501) 812-4972

NPI assigned

Sep 19, 2008

Last updated

Oct 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Orthopedic Rehabilitation Centers LLCGroup PAC ID 3678560695, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopedic Rehabilitation Centers LLC

  • Physical Therapist
  • Little Rock, AR
  • NPI 1780692491
  Medicare reassignment Care Compare group NPD
• Hunt Physical Therapy, LLC

  • Specialist
  • N Little Rock, AR
  • NPI 1811944614

  Physical Therapist

  Medicare reassignment NPD
• Boaz & Associates, Inc.

  dba Delta Rehab

  • Physical Therapy Clinic/Center
  • Wynne, AR
  • NPI 1518011816
  NPD (past)

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1083864649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "008-824-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W PERSHING BLVD STE D",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142157",
            "telephone_number": "501-812-4970",
            "fax_number": "501-812-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDUMANGE",
        "first_name": "IDUMANGE",
        "middle_name": "T.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Holehouse
• Robert William Holt
• Homelink Home Health Care (Alliance Homecare Equipment)
• Horizon Orthorehab Clinic, LTD (Horizon OrthoRehab and Diagnostics)
• Hunt Physical Therapy, LLC
• Imaging Solutions of Arkansas, LLC
• Ivory Durable Medical Equipmemt
• JM Professionals, in
• Amber N Johnson
• Yomika L Johnson, OT

• Physical Therapist in N Little Rock, AR
• Providers in N Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.