NPIMap

Organization Active NPI

Community Rehab, Inc

  • Physical Therapist
  • Valley, NE
National Provider Identifier
1265541007
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
N/A Issued in NE
Legal business name
COMMUNITY REHAB, INC
Practice address
208 N Spruce St
Valley, NE 68064-3418
Phone
(402) 359-1378
Fax
(402) 359-1598
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Mary J Theiler, MPT
Title
Owner/Physical Therapist
Phone
(402) 721-3908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X N/A NE Primary

Addresses

Primary practice location

208 N Spruce St
Valley, NE 68064-3418

Mailing address

208 N Spruce St
Valley, NE 68064-3418
Phone (402) 359-1378

Other identifiers 6

IdentifierTypeStateIssuer
0586339MedicaidIA
01805OtherNEBLUE CROSS BLUE SHIELD
10025335100MedicaidNE
S561OtherNEMIDLANDS CHOICE
6400599MedicaidNE
83270OtherNECOVENTRY

Other names 1

  • Community Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000486 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173428562 Receives reassigned benefits from 29 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, NE; South Sioux City, NE; Plattsmouth, NE; Omaha, NE; La Vista, NE

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1265541007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N SPRUCE ST",
            "city": "VALLEY",
            "state": "NE",
            "postal_code": "680643418",
            "telephone_number": "402-359-1378",
            "fax_number": "402-359-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N SPRUCE ST",
            "city": "VALLEY",
            "state": "NE",
            "postal_code": "680643418",
            "telephone_number": "402-359-1378",
            "fax_number": "402-359-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "THEILER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "402-721-3908",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0586339",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01805",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025335100",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "S561",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6400599",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "83270",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valley, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.