Patient First Rehabilitation LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PATIENT FIRST REHABILITATION LLC

Practice address

10205 Hickory Valley Dr
Fort Wayne, IN 46835-9558

Phone

(260) 312-0026

NPI assigned

Jun 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Andrew T Wagner, PT COMMA ATC

Title

PT Owner

Phone

(260) 312-0026

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154523132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10205 HICKORY VALLEY DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359558",
            "telephone_number": "260-312-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10205 HICKORY VALLEY DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359558",
            "telephone_number": "260-312-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT FIRST REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PT OWNER",
        "authorized_official_telephone_number": "260-312-0026",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT COMMA  ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.