NPIMap

Organization Active NPI

Prorehab Inc

Doing business as ProRehab of Illinois, Inc

  • Physical Therapy Clinic/Center
  • Effingham, IL
National Provider Identifier
1124652102
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PROREHAB INC
Doing business as
ProRehab of Illinois, Inc
Practice address
1302 Avenue of Mid America Ste 3
Effingham, IL 62401-4647
Phone
(217) 606-3004
Fax
(217) 717-2190
NPI assigned
Feb 27, 2020
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PROREHAB INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Andrea L. Baumann
Title
Coo
Phone
(812) 759-7473

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1302 Avenue of Mid America Ste 3
Effingham, IL 62401-4647

Mailing address

PO Box 5629
Evansville, IN 47716-5629
Phone (812) 759-7476

Other practice location 1

507 W Washington St
Newton, IL 62448-1247
Phone (217) 606-3004

Other names 1

  • ProRehab of Illinois, Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200702001488 IL Part B Supplier - Clinic/Group Practice 1254317217 Receives reassigned benefits from 8 practitioners
Practice locations: Carmi, IL; Effingham, IL; Mattoon, IL; Newton, IL

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Laura M Happe TR19 organizations share this tax ID, including this one
Part of
Laura M Happe TR

Other organizations with this tax ID 18

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

View all 18

Locations

1706 W Main St
Carmi, IL 62821
Phone (618) 384-7872

1302 Avenue of Mid America
Ste 3
Effingham, IL 62401
Phone (217) 606-3004

1302 Avenue of Mid America
Ste 4
Effingham, IL 62401
Phone (217) 606-3004

1813 Broadway Ave
Mattoon, IL 61938
Phone (217) 691-0690

507 W Washington St
Newton, IL 62448
Phone (217) 606-3004

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1124652102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5629",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477165629",
            "telephone_number": "812-759-7476",
            "fax_number": "812-773-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 AVENUE OF MID AMERICA STE 3",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014647",
            "telephone_number": "217-606-3004",
            "fax_number": "217-717-2190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "IL",
            "postal_code": "624481247",
            "country_code": "US",
            "telephone_number": "217-606-3004",
            "fax_number": "217-717-2190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROREHAB INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROREHAB INC",
        "enumeration_date": "2020-02-27",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "BAUMANN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "812-759-7473"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProRehab of Illinois, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.