NPIMap

Organization Active NPI

Community Rehab, Inc

Doing business as Community Rehab

  • Physical Therapist
  • Bellevue, NE
National Provider Identifier
1093824831
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
N/A Issued in NE
Legal business name
COMMUNITY REHAB, INC
Doing business as
Community Rehab
Practice address
1103 Galvin Rd South Area a
Bellevue, NE 68005-3002
Phone
(402) 408-0890
Fax
(402) 408-0892
NPI assigned
Aug 29, 2006
Last updated
May 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Mary J Theiler, MPTNPI 1497737712
Title
Owner/Physical Therapist
Phone
(402) 721-3908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X N/A NE Primary

Addresses

Primary practice location

1103 Galvin Rd South Area a
Bellevue, NE 68005-3002

Mailing address

1103 Galvin Road South Area a
Bellevue, NE 68005
Phone (402) 408-0890

Other identifiers 6

IdentifierTypeStateIssuer
83270OtherNECOVENTRY
193153204OtherNEDOL-OWCP
0586339MedicaidIA
S561OtherNEMIDLANDS CHOICE
6400338MedicaidNE
01805OtherNEBLUE CROSS BLUE SHIELD

Other names 1

  • Community Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000486 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173428562 Receives reassigned benefits from 29 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, NE; South Sioux City, NE; Plattsmouth, NE; Omaha, NE; La Vista, NE

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1093824831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 GALVIN ROAD SOUTH AREA A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "68005",
            "telephone_number": "402-408-0890",
            "fax_number": "402-408-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 GALVIN RD SOUTH AREA A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053002",
            "telephone_number": "402-408-0890",
            "fax_number": "402-408-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "THEILER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "402-721-3908",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "83270",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL-OWCP",
            "identifier": "193153204",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0586339",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "S561",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6400338",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01805",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.