Superior Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1484 Issued in NE

Legal business name

SUPERIOR PHYSICAL THERAPY LLC

Practice address

308 N Central Ave
Superior, NE 68978-1715

Phone

(402) 879-0109

Fax

(866) 764-0606

NPI assigned

Oct 25, 2015

Last updated

Jan 7, 2020By 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

Bradley J Gardner, MPTNPI 1821267550

Title

Sole Member

Phone

(402) 879-0109

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 3

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.

• Bradley J Gardner, PT

  • Physical Therapist
  • Superior, NE
  • NPI 1821267550
  Medicare reassignment NPD Authorized official
• Holly Beavers, DPT

  • Physical Therapist
  • Belleville, KS
  • NPI 1568970739

  NE

  Medicare reassignment NPD
• Denise McClurg, CPTA

  • Physical Therapy Assistant
  • Superior, NE
  • NPI 1548092372
  NPD (past)

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

{
    "created_epoch": "1445731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1275905689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 263",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689780263",
            "telephone_number": "402-879-1267",
            "fax_number": "866-764-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N CENTRAL AVE",
            "city": "SUPERIOR",
            "state": "NE",
            "postal_code": "689781715",
            "telephone_number": "402-879-0109",
            "fax_number": "866-764-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-25",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "402-879-0109",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NE",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Lynne Souerdyke, PHARM D
• South Central Behavioral Services
• Jett Stenson, M.S., CCC-SLP
• Rebekka Stephens
• Superior Pharmacy, Inc.
• Superior Vision PC
• Stephanie Svoboda, D.D.S
• Teachworth Chiropractic LLC
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Superior)
• The Evangelical Lutheran Good Samaritan Society (Victorian Legacy)

• Physical Therapy Clinic/Center in Superior, NE
• Providers in Superior, NE by specialty
• Physical Therapy Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.