Phaup Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1050 Issued in KY

Legal business name

PHAUP PHYSICAL THERAPY, LLC

Practice address

95 YMCA Dr
Suite a
Madisonville, KY 42431-9035

Phone

(270) 452-2188

Fax

(270) 245-2995

NPI assigned

Aug 17, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Mary Selena Phaup, PTNPI 1558551150

Title

Owner

Phone

(270) 452-2188

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

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

• Mary Selena Phaup

  • Physical Therapist
  • Madisonville, KY
  • NPI 1558551150
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1144775453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 YMCA DR",
            "address_2": "SUITE A",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319035",
            "telephone_number": "270-452-2188",
            "fax_number": "270-245-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 YMCA DR",
            "address_2": "SUITE A",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319035",
            "telephone_number": "270-452-2188",
            "fax_number": "270-245-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAUP PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "PHAUP",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-452-2188",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Noele Petersen, APRN
• Anthony Petroff, CRNA
• Russell E Peyton, NP
• Sarah Ruth Peyton, FNP
• Phaup Chiropractic Center, LLC
• Mary Selena Phaup
• Candida Phelps
• Charles D Phelps, RN
• Susan Lynn Phelps, M.S.
• Nicole Pickerel

• Physical Therapist in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.