Organization Active NPI

Neurortho Rehab Services, P.a.

  • Physical Therapy Clinic/Center
  • Pine Bluff, AR
National Provider Identifier
1114161015
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT1522 Issued in AR
Legal business name
NEURORTHO REHAB SERVICES, P.A.
Practice address
2502 W 28TH Ave
Pine Bluff, AR 71603-5054
Phone
(870) 534-0543
Fax
(870) 534-0541
NPI assigned
Apr 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

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

Authorized official

Name
Mr. Regin John Reginio, P.T.NPI 1881602936
Title
President
Phone
(870) 534-0543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT1522 AR Primary

Addresses

Primary practice location

2502 W 28TH Ave
Pine Bluff, AR 71603-5054

Mailing address

PO Box 1750
Pine Bluff, AR 71613-1750
Phone (870) 534-0543

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090511000517 AR Part B Supplier - Clinic/Group Practice 3173671633 Receives reassigned benefits from 1 practitioner
Practice locations: Pine Bluff, AR

National Provider Directory

National Provider Directory

Locations

2502 W 28th Ave
Pine Bluff, AR 71603
Phone (870) 534-0543

Practitioners & affiliated clinicians

Practitioners 1

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": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1114161015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1750",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716131750",
            "telephone_number": "870-534-0543",
            "fax_number": "870-534-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035054",
            "telephone_number": "870-534-0543",
            "fax_number": "870-534-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURORTHO REHAB SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "REGINIO",
        "authorized_official_first_name": "REGIN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-534-0543",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AR",
            "license": "PT1522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; 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.