NPIMap

Advanced PT, LLC

Organization Active NPI Physical Therapist · Park City, KS

NPI 1154963288 · NPPES record last updated Oct 10, 2019

Key facts

NPI
1154963288
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
ADVANCED PT, LLC
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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 27

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

View all 27

Corporate family (same tax ID) 22

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records

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…

National Provider Directory

Tax ID family
Preferred PT Nampa (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 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

  • Advanced PT Park City Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 10, 2019.

{
    "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY 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

All providers in Park City, KS · Physical Therapist in Kansas

Sources for this page

Verify at the official NPI Registry.