NPIMap

Organization Active NPI

Radius PT of Alabama LLC

  • Physical Therapy Clinic/Center
  • Trussville, AL
National Provider Identifier
1124790480
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RADIUS PT OF ALABAMA LLC
Doing business as
Radius PT of Alabama LLC
Practice address
7270 Gadsden Hwy # 104-108
Trussville, AL 35173-2640
Phone
(659) 444-1193
Fax
(205) 895-6639
NPI assigned
Oct 4, 2021
Last updated
Nov 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Brad KeislingNPI 1366471906
Title
Director of Corporate Operations
Phone
(843) 441-0595

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Clinic/Center 261Q00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

7270 Gadsden Hwy # 104-108
Trussville, AL 35173-2640

Mailing address

7270 Gadsden Hwy # 104-108
Trussville, AL 35173-2640
Phone (659) 444-1193

Other practice location 1

2208 Village Dr
Moody, AL 35004-3241
Phone (555) 833-5378

Other names 2

  • Radius PT of Alabama LLC Doing business as
  • Legacy PT of Alabama LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220318002331 AL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3476948951 Receives reassigned benefits from 11 practitioners
Practice locations: Moody, AL; Trussville, AL

National Provider Directory

National Provider Directory

Locations

2208 Village Dr
Moody, AL 35004
Phone (555) 833-5378

7270 Gadsden Hwy
#104108
Trussville, AL 35173
Phone (659) 444-1193

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1124790480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7270 GADSDEN HWY # 104-108",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351732640",
            "telephone_number": "659-444-1193",
            "fax_number": "205-895-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7270 GADSDEN HWY # 104-108",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351732640",
            "telephone_number": "659-444-1193",
            "fax_number": "205-895-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2208 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Moody",
            "state": "AL",
            "postal_code": "350043241",
            "country_code": "US",
            "telephone_number": "555-833-5378",
            "fax_number": "855-966-4084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADIUS PT OF ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-04",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "KEISLING",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "DIRECTOR OF CORPORATE OPERATIONS",
        "authorized_official_telephone_number": "843-441-0595"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "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": "Radius PT of Alabama LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legacy PT of Alabama LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Legacy PT of Alabama LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Trussville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.