Lundholm Surgical Group Physical Therapy DPT

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LUNDHOLM SURGICAL GROUP PHYSICAL THERAPY DPT

Practice address

1340 Charles St
Rockford, IL 61104-2200

Phone

(815) 399-1975

Fax

(815) 399-3207

NPI assigned

May 17, 2007

Last updated

Aug 22, 2020By 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

Janna P. King, JD

Title

VP, Authorized Official

Phone

(713) 297-7000

Specialties & licenses 1

Addresses

Tax ID family

Lundholm Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lundholm Physical Therapy

  • Physical Therapy Clinic/Center
  • Rockford, IL
  • NPI 1154407831
  NPD tax ID

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174730014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422447",
            "telephone_number": "713-297-7000",
            "fax_number": "713-297-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "815-399-1975",
            "fax_number": "815-399-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNDHOLM SURGICAL GROUP PHYSICAL THERAPY DPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JANNA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VP, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Harry Lund, M.D.
• Amy Lundgren, RN
• Annie Mae Lundgren
• Lundholm Physical Therapy
• Lundholm Surgical Group LTD
• Denise Lynn Lundine
• Mark L. Lundine
• Abigail Pam Lundquist, PA-C
• Alexandra Lundsteen, MS, LMFT, CADC
• Nichole Suzanne Lupei, D.O.

• Durable Medical Equipment & Medical Supplies in Rockford, IL
• Providers in Rockford, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.