Individual provider Active NPI

Joshua Charles Butcher, PT

  • Physical Therapist
  • Fort Wayne, IN
National Provider Identifier
1164838462
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
99062094A Issued in IN
Practice address
6410 W Jefferson Blvd Ste 15a
Fort Wayne, IN 46804-6282
Phone
(260) 299-7272
Fax
(260) 299-7273
NPI assigned
Jul 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36001889A IN
Physical Therapist 225100000X 99062094A IN Primary

Addresses

Primary practice location

6410 W Jefferson Blvd Ste 15a
Fort Wayne, IN 46804-6282

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131002863 IN Practitioner - Physical Therapist in Private Practice 0244683795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Rehabilitation Services LLCGroup PAC ID 2264479518, 569 clinicians

Practice addresses (Care Compare)

613 W Lincoln Rd
Team Rehabilitation In10
Kokomo, IN 46902-3460
Phone (765) 416-6630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99062094AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Therapy on Wheels, Inc. Physical Therapist CurrentSince Jan 27, 2024 Accepting new patients
Indiana Physical Therapy, Inc Physical Therapist Past Accepting new patients

Locations

6410 W Jefferson Blvd
Ste 15A
Fort Wayne, IN 46804
Phone (260) 299-7272

6410 W Jefferson Blvd
Ste G15A
Fort Wayne, IN 46804
Phone (260) 299-7272

1992 E Stop 13 Rd
Indianapolis, IN 46227
Phone (317) 808-0230

613 W Lincoln Rd
#10
Kokomo, IN 46902
Phone (765) 416-6630

613 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 319-3522

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

Organizations & group practices 4

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1164838462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 W JEFFERSON BLVD STE 15A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046282",
            "telephone_number": "260-299-7272",
            "fax_number": "260-299-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTCHER",
        "first_name": "JOSHUA",
        "middle_name": "CHARLES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001889A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "99062094A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.