NPIMap

Organization Active NPI

Total Rehabilitation, Inc

  • Physical Therapist
  • Fort Smith, AR
National Provider Identifier
1104909118
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1835 Issued in AR
Legal business name
TOTAL REHABILITATION, INC
Practice address
5905 Remington Cir
Fort Smith, AR 72903-6523
Phone
(479) 452-7773
Fax
(479) 452-7774
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Authorized official

Name
Brooke E Elliott
Title
Office Manager
Phone
(479) 452-7773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT1835 AR Primary

Addresses

Primary practice location

5905 Remington Cir
Fort Smith, AR 72903-6523

Mailing address

PO Box 11122
Fort Smith, AR 72917-1122
Phone (479) 452-7773

Other identifiers 1

IdentifierTypeStateIssuer
136730742MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080305000682 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214012962 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Smith, AR

National Provider Directory

National Provider Directory

Locations

5905 Remington Cir
Fort Smith, AR 72903
Phone (479) 452-7773

7320 Rogers Ave
Ste 26
Fort Smith, AR 72903
Phone (474) 452-7773

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1104909118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11122",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171122",
            "telephone_number": "479-452-7773",
            "fax_number": "479-452-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 REMINGTON CIR",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036523",
            "telephone_number": "479-452-7773",
            "fax_number": "479-452-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-452-7773"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136730742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.