NPIMap

Organization Active NPI

Rehab, Etc., Inc.

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1104032465
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
204667 Issued in TN
Legal business name
REHAB, ETC., INC.
Practice address
871 Ridgeway Loop Rd Ste 100
Memphis, TN 38120-4026
Phone
(901) 759-1282
Fax
(901) 759-1290
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Authorized official

Name
Mrs. Phyllis Knose
Title
Vice Presidant
Phone
(901) 759-1282

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 204667 TN Primary
Geriatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251G0304X 204667 TN
Neurology Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251N0400X 204667 TN
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X 204667 TN
Rehabilitation PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225400000X 204667 TN
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 204667 TN
Rehabilitation Clinic/Center 261QR0400X 0446575 TN

Addresses

Primary practice location

871 Ridgeway Loop Rd Ste 100
Memphis, TN 38120-4026

Mailing address

871 Ridgeway Loop Rd Ste 100
Memphis, TN 38120-4026
Phone (901) 759-1282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120216000514 TN Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5890603039 Practice locations: Oakland, TN; Bartlett, TN; Memphis, TN

National Provider Directory

National Provider Directory

Locations

8070 US Highway 64
Ste 104
Bartlett, TN 38133
Phone (901) 266-3838

3045 N Germantown Rd
#1
Bartlett, TN 38133

3045 N Germantown Rd
Bartlett, TN 38133
Phone (901) 266-3838

2059 S Houston Levee Rd
Ste 117
Germantown, TN 38139
Phone (901) 221-9221

5220 Park Ave
Ste 200
Memphis, TN 38119
Phone (901) 682-2522

1789 Kirby Pkwy
Ste 3
Memphis, TN 38138
Phone (901) 759-1282

871 Ridgeway Loop Rd
Ste 100
Memphis, TN 38120
Phone (901) 221-9221

6250 Highway 64
Ste 5
Oakland, TN 38060
Phone (901) 255-6545

6250 Highway 64
Oakland, TN 38060

Practitioners & affiliated clinicians

Practitioners 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1104032465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 RIDGEWAY LOOP RD STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204026",
            "telephone_number": "901-759-1282",
            "fax_number": "901-759-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 RIDGEWAY LOOP RD STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204026",
            "telephone_number": "901-759-1282",
            "fax_number": "901-759-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB, ETC., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "KNOSE",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "VICE PRESIDANT",
        "authorized_official_telephone_number": "901-759-1282",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "204667",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "TN",
            "license": "204667",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": "TN",
            "license": "204667",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "204667",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "TN",
            "license": "204667",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "204667",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TN",
            "license": "0446575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.