George William Loze, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Whitley City, KY
NPI 1093801003 · NPPES record last updated Aug 24, 2018
Key facts
- NPI
- 1093801003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 000953 (KY)
- Practice address
- 551 N Highway 27
Whitley City, KY 42653-4083 - Phone
- (606) 376-8020
- Fax
- (606) 376-8055
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lighthouse Physical Therapy, Inc.
Practice addresses (Care Compare)
551 N Hwy 27
Whitley City, KY 42653-4083
Phone (606) 376-8020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071012000051 | KY | Practitioner - Physical Therapist in Private Practice | 6608972393 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000953 | KY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Physical Therapy, Inc. | Current |
Accepting new patients |
Locations
551 N Highway 27
Whitley City, KY 42653
Phone (606) 376-4199
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 000953 | KY | Yes |
Addresses
Primary practice location
551 N Highway 27
Whitley City, KY 42653-4083
Mailing address
PO Box 936
Whitley City, KY 42653-0936
Phone (606) 376-8020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000543321 | Other | KY | ANTHEM BC/BS |
| 7100014340 | Medicaid | KY | |
| 1185497 | Other | KY | CHA PROVIDER NUMBER |
| P00422439 | Other | KY | RAILROAD MEDICARE |
Other providers in Whitley City, KY
- Lake Cumberland District Heatlh Dept
- Ashok Kumar Lakhiani
- Terry Lawson
- Lighthouse Physical Therapy, Inc.
- Nicole Shaylyn Link
- Tiffani Maggard
- Maranda Manning
- Charlotte Louise Marlow
- Jessica Ann Mason
- McCreary County Judge
All providers in Whitley City, KY · Physical Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.