Individual provider Active NPI

David E Cobb, PT

  • Physical Therapist
  • Lafayette, IN
National Provider Identifier
1154401925
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05002669A Issued in IN
Practice address
3806 Amelia Ave
Lafayette, IN 47905-5772
Phone
(765) 807-2773
Fax
(765) 807-2774
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 05002669A IN
Physical Therapist 225100000X 05002669A IN Primary

Addresses

Primary practice location

3806 Amelia Ave
Lafayette, IN 47905-5772

Mailing address

PO Box 4699
Lafayette, IN 47903-4699
Phone (765) 449-2732

Other practice location 1

152 Sagamore Pkwy W
West Lafayette, IN 47906-1569
Phone (765) 463-2200

Other identifiers 2

IdentifierTypeStateIssuer
000000496786OtherINANTHEM
201164480MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070326000065 IN Practitioner - Physical Therapist in Private Practice 3476657826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miracles Rehabilitation LLCGroup PAC ID 2567998750, 10 clinicians

Practice addresses (Care Compare)

3806 Amelia Ave
Lafayette, IN 47905-5772
Phone (765) 807-2773

424 W Division St
Remington, IN 47977-8715
Phone (219) 208-3008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05002669AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Healthcare, LLC CurrentSince Jun 1, 2006 Accepting new patients
Unity Healthcare, LLC Current Accepting new patients
Miracles Rehabilitation LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Unity Healthcare LLC CurrentSince Jun 1, 2006 Accepting new patients
Unity Healthcare LLC Physical Therapist PastSince Dec 1, 2023 Accepting new patients

Locations

1345 Unity Pl
Ste 235
Lafayette, IN 47905
Phone (765) 446-5065

3806 Amelia Ave
Lafayette, IN 47905
Phone (765) 807-2773

307 Sagamore Pkwy W
Ste 400
West Lafayette, IN 47906
Phone (765) 463-2000

152 Sagamore Pkwy W
West Lafayette, IN 47906
Phone (765) 423-6556

257 Sagamore Pkwy W
West Lafayette, IN 47906
Phone (765) 463-2200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1154401925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4699",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479034699",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 AMELIA AVE",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055772",
            "telephone_number": "765-807-2773",
            "fax_number": "765-807-2774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Sagamore Pkwy W",
            "address_purpose": "LOCATION",
            "city": "West Lafayette",
            "state": "IN",
            "postal_code": "479061569",
            "country_code": "US",
            "telephone_number": "765-463-2200",
            "fax_number": "765-463-3625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBB",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "IN",
            "license": "05002669A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002669A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000496786",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201164480",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.