NPIMap

Organization Active NPI

Rehabvisions Therapy Wa, LLC

Doing business as RehabVisions

  • Physical Therapy Clinic/Center
  • South Bend, WA
National Provider Identifier
1265823694
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
REHABVISIONS THERAPY WA, LLC
Doing business as
RehabVisions
RehabVisions South Bend
Practice address
1010 W Robert Bush Drive
South Bend, WA 98586-0610
Phone
(360) 875-5543
Fax
(360) 875-5544
NPI assigned
Feb 6, 2015
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Theresa Lynn Godfrey
Title
Clinic Admin/RCM Director
Phone
(402) 334-6025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1010 W Robert Bush Drive
South Bend, WA 98586-0610

Mailing address

11623 Arbor St
Omaha, NE 68144-2981
Phone (402) 334-1919

Other names 2

  • RehabVisions Doing business as
  • RehabVisions South Bend Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150507000095 WA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2961721378 Receives reassigned benefits from 2 practitioners
Practice locations: South Bend, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1265823694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11623 ARBOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442981",
            "telephone_number": "402-334-1919",
            "fax_number": "402-758-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W ROBERT BUSH DRIVE",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985860610",
            "telephone_number": "360-875-5543",
            "fax_number": "360-875-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABVISIONS THERAPY WA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINIC ADMIN/RCM DIRECTOR",
        "authorized_official_telephone_number": "402-334-6025"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RehabVisions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RehabVisions South Bend",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RehabVisions South Bend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.