Total Life Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

05008539A Issued in IN

Legal business name

TOTAL LIFE PHYSICAL THERAPY LLC

Practice address

5 Public SQ
Salem, IN 47167-2050

Phone

(812) 883-5454

Fax

(812) 883-6464

NPI assigned

Jun 19, 2007

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia M Martin, PT

Title

Owner

Phone

(812) 883-5454

Specialties & licenses 2

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1275738221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471670425",
            "telephone_number": "812-883-5454",
            "fax_number": "812-883-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PUBLIC SQ",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672050",
            "telephone_number": "812-883-5454",
            "fax_number": "812-883-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL LIFE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-883-5454",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IN",
            "license": "05008539A",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11775364",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841335056",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007714984",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "089937",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHN",
            "identifier": "38856",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000535153",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Reed Tate, M.D.
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• The Health and Hospital Corporation of Marion County (Meadow View Health and Rehabilitation)
• The Health and Hospital Corporation of Marion County (Salem Crossing)
• Cassidy Leigh Tonkin
• Elijah Voyles, DC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-7087)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-7087)
• Walgreen Co (Walgreens #17009)
• Olivia S. Walker, O.D.

• Physical Therapy Clinic/Center in Salem, IN
• Providers in Salem, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.