Classic Rehabilitation Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1070613 Issued in TX

Legal business name

CLASSIC REHABILITATION INC

Practice address

504 N Carrier Parkway
Grand Prairie, TX 75050-5428

Phone

(972) 263-7042

Fax

(972) 263-7046

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin L Jones Jr., DPTNPI 1306006606

Title

Ceo

Phone

(972) 263-7042

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Outpatient physical therapy / speech pathology certification: CCN 456786

Legal name

CLASSIC REHABILITATION INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Feb 15, 1997

Last certification

Feb 27, 2018

Ownership / control type

Proprietary

Facility address

504 North Carrier Parkway
Grand Prairie, TX 75050

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martin L Jones, PT, CWS

  • Physical Therapist
  • Grand Prairie, TX
  • NPI 1306006606
  NPD (past) Authorized official
• Miriah C Hadley, DPT

  • Physical Therapist
  • Grand Prairie, TX
  • NPI 1255929212
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1093746034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531513",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750531513",
            "telephone_number": "972-263-7042",
            "fax_number": "972-263-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N CARRIER PARKWAY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505428",
            "telephone_number": "972-263-7042",
            "fax_number": "972-263-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-263-7042",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1070613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chyma Care Services
• City of Grand Prairie
• Ajala Bell Clark
• Amaya Clark, MS. BCBA, LBA
• Chantell Lee' Patrice Clark
• Clear Vision Eyecare PLLC.
• Click Wheelchair Services
• Clinica Integral Familia Sana LLC
• Clinica Medica Salve PLLC
• Clinica Medica Salve PLLC

• Physical Therapy Clinic/Center in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.