Omaha Sports Physical Therapy, PC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Legal business name

OMAHA SPORTS PHYSICAL THERAPY, PC

Practice address

12100 W Center Rd
Suite 525
Omaha, NE 68144-3969

Phone

(402) 330-2774

Fax

(402) 330-2779

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David H. Potach, P.T.NPI 1306911433

Title

Owner

Phone

(402) 330-2774

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David H. Potach, P.T.

  • Orthopedic Physical Therapist
  • Omaha, NE
  • NPI 1306911433
  NPD (past) Authorized official

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1144394164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 W CENTER RD",
            "address_2": "SUITE 525",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443969",
            "telephone_number": "402-330-2774",
            "fax_number": "402-330-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 W CENTER RD",
            "address_2": "SUITE 525",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443969",
            "telephone_number": "402-330-2774",
            "fax_number": "402-330-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAHA SPORTS PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "POTACH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-330-2774",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024986200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Omaha, NE
• Providers in Omaha, NE by specialty
• Orthopedic Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.