Progressive Rehab, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004092L Issued in PA

Legal business name

PROGRESSIVE REHAB, LLC

Practice address

2305 N. Broad Street
Lower Level
Philadelphia, PA 19132

Phone

(215) 223-6548

Fax

(215) 245-5615

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Guarnaccia

Title

Partner

Phone

(215) 223-6548

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Progressive Rehab, LLC Former legal business name

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1154536860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 755",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190020755",
            "telephone_number": "215-223-6548",
            "fax_number": "215-245-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 N. BROAD STREET",
            "address_2": "LOWER LEVEL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19132",
            "telephone_number": "215-223-6548",
            "fax_number": "215-245-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "GUARNACCIA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "215-223-6548"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT004092L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "32298",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2581987",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Rehab, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.