Powerback Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

POWERBACK REHABILITATION LLC

Doing business as

Powerback Rehabilitation

Practice address

278 Clermont Dr
Festus, MO 63028-4260

Phone

(610) 925-1176

NPI assigned

Oct 23, 2024

Last updated

Feb 21, 2025By 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

Ian OppelNPI 1245002708

Title

Coo

Phone

(980) 254-7007

Specialties & licenses 3

Addresses

Other names 1

• Powerback Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Tax ID family

Genesis Healthcare Inc209 organizations share this tax ID, including this one

All facility ownership & control disclosures 25

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 22

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.

• Aja Bethany, OTR

  • Occupational Therapist
  • Saint Louis, MO
  • NPI 1073889739
  Medicare reassignment Care Compare group NPD
• Tammy Lynne Boruch, PT

  • Physical Therapist
  • Polo, MO
  • NPI 1053624874
  Medicare reassignment Care Compare group NPD
• Janelle L Brownfield, R.P.T.

  • Physical Therapist
  • Kansas City, MO
  • NPI 1417200569
  Medicare reassignment Care Compare group NPD
• Ka Cheuk, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mount Vernon, MO
  • NPI 1124693742
  Medicare reassignment Care Compare group NPD
• Stacey D Davison, PT

  • Physical Therapist
  • Cape Girardeau, MO
  • NPI 1497584247
  Medicare reassignment Care Compare group NPD
• Brooke Danielle Doak, MS CFY-SLP

  • Speech-Language Pathologist
  • Kansas City, MO
  • NPI 1952931685
  Medicare reassignment Care Compare group NPD
• Kellie Christina Elmore, P.T.

  • Physical Therapist
  • Owensville, MO
  • NPI 1396127072
  Medicare reassignment Care Compare group NPD
• Jennifer Garner, DPT

  • Physical Therapist
  • Nixa, MO
  • NPI 1366764516
  Medicare reassignment Care Compare group NPD
• Dawnya Mae Gibbs

  • Occupational Therapist
  • Joplin, MO
  • NPI 1265766075
  Medicare reassignment Care Compare group NPD
• April Sunshine Gilliland

  • Speech-Language Pathologist
  • Kansas City, MO
  • NPI 1689793564
  Medicare reassignment Care Compare group NPD
• Alex Hobbs, DPT

  • Physical Therapist
  • Mexico, MO
  • NPI 1992365464
  Medicare reassignment Care Compare group NPD
• Cathy Kossuth, RPT

  • Physical Therapist
  • Saint James, MO
  • NPI 1295892214
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1174344063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "800-728-8808",
            "fax_number": "610-347-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 CLERMONT DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284260",
            "telephone_number": "610-925-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERBACK REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-23",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "OPPEL",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "980-254-7007"
    },
    "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
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powerback Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Powerback Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Festus, MO
• Providers in Festus, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.