Buckeye Senior Rehab LLC
Organization Active NPI Physical Therapist · Lebanon, IN
NPI 1124727573 · NPPES record last updated Feb 24, 2023
Key facts
- NPI
- 1124727573
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- BUCKEYE SENIOR REHAB LLC
- Practice address
- 1102 S Lebanon St
Lebanon, IN 46052-2717 - Phone
- (937) 291-3780
- NPI assigned
- Feb 24, 2023
- Organization subpart
- No
Authorized official
- Name
- Tina Hardwick
- Title
- Owner
- Phone
- (937) 291-3780
Other NPIs with the same Medicare PAC ID 2
Practitioners 16
-
Ruth Ann Boris, MA, CCC-SLP
-
Janet Marie Clark, OTRL
-
Keri Evans, OTR/L
-
Phillip Hotz, DPT
-
Dustin Menetrey, PT, DPT
-
Ryan Scott Roush, PT, DPT
-
Carolyn Sebourn, CCC-SLP
-
Corina Sparks, DPT
-
Carolyn Weis, CCC-SLP
-
Mary Kay Yeager, OT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230307002281 | IN | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 4284017542 | Practice locations: Lebanon, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
1102 S Lebanon St
Lebanon, IN 46052-2717
Mailing address
1102 S Lebanon St
Lebanon, IN 46052-2717
Phone (937) 291-3780
Other names
- Heritage Senior Rehab
Other providers in Lebanon, IN
- Patricia Brown
- Whitney T Brown
- Valerie Susan Bruemmer
- Robin M Bruner
- Heather Bruno
- Chelsea Budd
- Brian W Buoscio
- Della J. Busby
- Melissa Marie Bush
- Terry W Bushnell
All providers in Lebanon, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.