Champion Physical Therapy Kentucky, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

CHAMPION PHYSICAL THERAPY KENTUCKY, LLC

Doing business as

CORA Physical Therapy - Middlesboro

Practice address

1475 US Highway 25 E Ste 6
Middlesboro, KY 40965-2077

Phone

(606) 248-1996

Fax

(606) 248-1901

NPI assigned

Jul 13, 2018

Last updated

Jul 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brad C. Roush

Title

Executive Vice President

Phone

(419) 221-6712

Specialties & licenses 1

Addresses

Other names 1

• CORA Physical Therapy - Middlesboro Doing business as

Tax ID family

Champion Physical Therapy Kentucky LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Champion Physical Therapy Kentucky LLC

  dba CORA Physical Therapy - Corbin

  • Rehabilitation Clinic/Center
  • Corbin, KY
  • NPI 1568001493
  NPD tax ID
• Champion Physical Therapy Kentucky, LLC

  dba CORA Physical Therapy - Somerset

  • Rehabilitation Clinic/Center
  • Somerset, KY
  • NPI 1689150682
  NPD tax ID

Locations

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1114403060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053529",
            "telephone_number": "419-221-6720",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 US HIGHWAY 25 E STE 6",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652077",
            "telephone_number": "606-248-1996",
            "fax_number": "606-248-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION PHYSICAL THERAPY KENTUCKY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Middlesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy Mills Capps
• Courtney Carroll, PHARM.D
• Mackenzie Carroll, DO
• Hope Madison Carter, PA-C
• Pamela Cavins, NP-C
• Champion Physical Therapy Kentucky, LLC (CORA Physical Therapy - Middlesboro)
• Leigh Ann Michelle Chappell, MA, CCC/SLP
• Charles a Moore
• City of Middlesboro (Middlesboro Fire Department Ambulance)
• Comprehensive Home Health Care Services, Inc. (Bell County Adult Day Care)

• Rehabilitation Clinic/Center in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Rehabilitation Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.