Advanced PT LLC
Organization Active NPI Physical Therapist · Wichita, KS
NPI 1134633738 · NPPES record last updated Nov 20, 2017
Key facts
- NPI
- 1134633738
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- ADVANCED PT LLC
- Practice address
- 1725 E Douglas Ave Ste 103
Wichita, KS 67211-1610 - Phone
- (316) 202-0987
- Fax
- (316) 202-0988
- NPI assigned
- Nov 20, 2017
- Organization subpart
- No
Authorized official
- Name
- David Charles Todd
- Title
- PT, Owner
- Phone
- (316) 263-0003
Other NPIs on the same Medicare enrollment 27
Corporate family (same tax ID) 22
Practitioners 2
-
Brenna Nolan, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060222000723 | KS | Part B Supplier - Clinic/Group Practice | 3678524709 |
Receives reassigned benefits from 102 practitioners 27 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Arkansas City, KS; Andover, KS; Winfield, KS; Wichita, KS; Wellington, KS; Sterling, KS; Park City, KS; Newton, KS… |
National Provider Directory
- Tax ID family
- Preferred PT Nampa
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
1725 E Douglas Ave Ste 103
Wichita, KS 67211-1610
Mailing address
200 W Douglas Ave Ste 1040
Wichita, KS 67202-3017
Phone (316) 263-0003
Other names
- Advanced PT Downtown
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2017. 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.