Premere Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PREMERE REHAB LLC

Doing business as

Infinity Rehab

Practice address

1525 Wigwam Pkwy
Henderson, NV 89074-8297

Phone

(702) 904-9943

NPI assigned

May 25, 2023

Last updated

May 25, 2023By 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

Tammy McCoy

Title

Credentialing Specialist

Phone

(971) 224-2841

Specialties & licenses 3

Addresses

Other names 1

• Infinity Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• Premere Rehab LLC

  dba Infinity Rehab LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1922305663

  O20110509000722

  Same enrollment
• Premere Rehab LLC

  dba Henderson

  • Physical Therapist
  • Henderson, NV
  • NPI 1932406675

  O20110509000722

  Same enrollment
• Premere Rehab LLC

  dba Infinity Rehab

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1932828316

  O20110509000722

  Same enrollment
• Premere Rehab LLC

  dba Infinity Rehab

  • Physical Therapist
  • Wilsonville, OR
  • NPI 1245278639

  O20110509000722

  Same enrollment

Practitioners 1

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.

• Kevin A Sumida, OT

  • Occupational Therapist
  • Las Vegas, NV
  • NPI 1548206790
  NPD

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1235821307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 SW NYBERG ST STE 200",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628437",
            "telephone_number": "503-570-3665",
            "fax_number": "503-570-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 WIGWAM PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890748297",
            "telephone_number": "702-904-9943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 S Meridian",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983717506",
            "country_code": "US",
            "telephone_number": "253-904-3535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMERE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "971-224-2841"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Infinity Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Precious Care Hospice Inc.
• Precision Orthotics & Prosthetics, LLC (ForMotion Clinic)
• Preferred Pain Management
• Preferred Pain Management, LLC
• Matthew Peter Prekupec, M.D.
• Premere Rehab LLC (Henderson)
• Premier Medical LLC
• Premier Medical Services Gandhi Patel Sonpatki PLLC (Premier Medical Services)
• Premier Orthopedic and Spine Institute PLLC (Premier OSI)
• Premier Personal Care LLC

• Physical Therapist in Henderson, NV
• Providers in Henderson, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.