NPIMap

Organization Active NPI

Advanced PT, LLC

Doing business as Advanced PT Park City

  • Physical Therapist
  • Park City, KS
National Provider Identifier
1154963288
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ADVANCED PT, LLC
Doing business as
Advanced PT Park City
Practice address
1755 E 61St St N
Park City, KS 67219-1917
Phone
(316) 361-5425
Fax
(316) 361-3615
NPI assigned
Oct 10, 2019
Last updated
Oct 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
David Charles ToddNPI 1992730204
Title
Owner
Phone
(316) 263-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

1755 E 61St St N
Park City, KS 67219-1917

Mailing address

200 W Douglas Ave Ste 1040
Wichita, KS 67202-3017
Phone (316) 263-0003

Other names 1

  • Advanced PT Park City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060222000723 KS Part B Supplier - Clinic/Group Practice 3678524709 Receives reassigned benefits from 102 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arkansas City, KS; Andover, KS; Winfield, KS; Wichita, KS; Wellington, KS; Sterling, KS; Park City, KS; Newton, KS…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory
Tax ID family
Advanced PT LLC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1154963288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 1040",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023017",
            "telephone_number": "316-263-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 E 61ST ST N",
            "city": "PARK CITY",
            "state": "KS",
            "postal_code": "672191917",
            "telephone_number": "316-361-5425",
            "fax_number": "316-361-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-263-0003"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced PT Park City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.