NPIMap

Organization Active NPI

Total Rehab Center, PSC

  • Physical Therapist
  • Somerset, KY
National Provider Identifier
1225061542
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TOTAL REHAB CENTER, PSC
Practice address
175 Medpark Drive
Somerset, KY 42503-2888
Phone
(606) 679-1761
Fax
(606) 678-0971
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Mr. Terry Randall
Title
Director/Owner
Phone
(606) 679-1761

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Rehabilitation Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0019X

Addresses

Primary practice location

175 Medpark Drive
Somerset, KY 42503-2888

Mailing address

175 Medpark Drive
Somerset, KY 42503-2888
Phone (606) 679-1761

Other identifiers 2

IdentifierTypeStateIssuer
87031803MedicaidKY
000000225875OtherKYBCBS GROUP NUMBER FOR PT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050728000440 KY Part B Supplier - Clinic/Group Practice 2466480751 Receives reassigned benefits from 13 practitioners
Practice locations: Somerset, KY

National Provider Directory

National Provider Directory

Locations

175 Medpark Dr
Somerset, KY 42503
Phone (606) 679-1761

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1225061542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MEDPARK DRIVE",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032888",
            "telephone_number": "606-679-1761",
            "fax_number": "606-678-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MEDPARK DRIVE",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032888",
            "telephone_number": "606-679-1761",
            "fax_number": "606-678-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL REHAB CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "606-679-1761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87031803",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER FOR PT",
            "identifier": "000000225875",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.