Edward L Valentine III, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004527 Issued in KY

Practice address

195 Commercial Dr Ste 100
London, KY 40744-5234

Phone

(606) 657-5111

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revolution Physical Therapy CorbinGroup PAC ID 9638612187, 4 clinicians

Revolution Physical TherapyGroup PAC ID 6507106812, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Kentucky Family Practice Inc

  • Rural Health Clinic/Center
  • London, KY
  • NPI 1851054597

  5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Revolution Physical Therapy

  • Physical Therapy Clinic/Center
  • London, KY
  • NPI 1992277107

  KY, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Revolution Physical Therapy Corbin

  • Physical Therapist
  • Corbin, KY
  • NPI 1861231524

  KY, Physical Therapist

  Medicare reassignment Care Compare group NPD
• PT Pros, Inc.

  • Physical Therapist
  • Elizabethtown, KY
  • NPI 1376088799

  KY, Physical Therapist

  Medicare reassignment NPD
• PT Pros, Inc.

  • Physical Therapist
  • Lafayette, LA
  • NPI 1164153839
  NPD

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1104928969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 COMMERCIAL DR",
            "address_2": "STE 100",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407445234",
            "telephone_number": "606-657-5111",
            "fax_number": "606-657-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 COMMERCIAL DR STE 100",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407445234",
            "telephone_number": "606-657-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINE",
        "first_name": "EDWARD",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in London, KY
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.