NPIMap

Organization Active NPI

Premere Rehab LLC

Doing business as Infinity Rehab

  • Physical Therapist
  • Washington, UT
National Provider Identifier
1245839547
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PREMERE REHAB LLC
Doing business as
Infinity Rehab
Practice address
1525 E Ovation PL
Washington, UT 84780
Phone
(435) 429-0000
Fax
(866) 728-9636
NPI assigned
Oct 19, 2020
Last updated
Oct 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Laura Cantrell, PTNPI 1588855126
Title
Regional Director of Outpatient Ops
Phone
(360) 901-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1525 E Ovation PL
Washington, UT 84780

Mailing address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Phone (971) 255-4079

Other names 1

  • Infinity Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111130000600 UT Part B Supplier - Clinic/Group Practice 2567434764 Receives reassigned benefits from 1 practitioner
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, UT

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Prairie Manor47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

Practitioners & affiliated clinicians

Practitioners 2

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": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1245839547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "971-255-4079",
            "fax_number": "888-795-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E OVATION PL",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "84780",
            "telephone_number": "435-429-0000",
            "fax_number": "866-728-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMERE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR OF OUTPATIENT OPS",
        "authorized_official_telephone_number": "360-901-8111",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Infinity Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.