Organization Active NPI

Southeast Arkansas Physical Therapy, Inc.

  • Physical Therapist
  • Pine Bluff, AR
National Provider Identifier
1245293950
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTHEAST ARKANSAS PHYSICAL THERAPY, INC.
Practice address
2801 S Olive St
Suite 9D
Pine Bluff, AR 71603-5439
Phone
(870) 541-0003
Fax
(870) 541-0008
NPI assigned
Apr 11, 2006
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Mr. Steve R Hornbeck, P.T.NPI 1326003435
Title
President
Phone
(870) 541-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

2801 S Olive St
Suite 9D
Pine Bluff, AR 71603-5439

Mailing address

2801 S Olive St
Suite 9D
Pine Bluff, AR 71603-5439
Phone (870) 541-0003

Other identifiers 7

IdentifierTypeStateIssuer
7099039OtherARAETNA
135098742MedicaidAR
147503400OtherARDEPT OF LABOR
CB6528OtherARMEDICARE RAILROAD
5C236OtherARHEALTH ADVANTAGE
5C236OtherARBLUE CROSS BLUE SHIELD
6420055OtherARUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051103000532 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7113945650 Receives reassigned benefits from 3 practitioners
Practice locations: Pine Bluff, AR

National Provider Directory

National Provider Directory

Locations

2801 S Olive St
Ste 9D
Pine Bluff, AR 71603
Phone (870) 541-0003

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1245293950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S OLIVE ST",
            "address_2": "SUITE 9D",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035439",
            "telephone_number": "870-541-0003",
            "fax_number": "870-541-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S OLIVE ST",
            "address_2": "SUITE 9D",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035439",
            "telephone_number": "870-541-0003",
            "fax_number": "870-541-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ARKANSAS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "HORNBECK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-541-0003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7099039",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135098742",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "147503400",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CB6528",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE",
            "identifier": "5C236",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C236",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6420055",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.