NPIMap

Organization Active NPI

Prorehab Louisville, LLC

  • Physical Therapy Clinic/Center
  • Louisville, KY
National Provider Identifier
1265800288
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PROREHAB LOUISVILLE, LLC
Practice address
169 S English Station Rd FL 1
Louisville, KY 40245-3996
Phone
(502) 245-1136
Fax
(502) 245-1146
NPI assigned
Sep 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Andrea L. Baumann, DPT
Title
Coo
Phone
(812) 759-7473

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Multi-Specialty Clinic/Center 261QM1300X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

169 S English Station Rd FL 1
Louisville, KY 40245-3996

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (812) 401-3258

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150316002327 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4587981337 Receives reassigned benefits from 72 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prospect, KY; Louisville, KY; Crestwood, KY; Jeffersontown, KY; La Grange, KY

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Prorehab Louisville LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

169 S English Station Rd
Fl 1
Louisville, KY 40245
Phone (502) 245-1136

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1265800288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "812-401-3258",
            "fax_number": "812-401-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 S ENGLISH STATION RD FL 1",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402453996",
            "telephone_number": "502-245-1136",
            "fax_number": "502-245-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB LOUISVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "BAUMANN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "812-759-7473",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.