NPIMap

Organization Active NPI

Advanced Physical Therapy Services, LTD

  • Physical Therapy Clinic/Center
  • Monmouth, IL
National Provider Identifier
1295472017
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ADVANCED PHYSICAL THERAPY SERVICES, LTD
Practice address
1201 E Broadway Ste C
Monmouth, IL 61462-1995
Phone
(309) 734-1103
Fax
(309) 734-2013
NPI assigned
May 13, 2022
Last updated
May 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Mark Steven Oertwig
Title
Director of Finance
Phone
(309) 661-8823

Specialties & licenses 1

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

Addresses

Primary practice location

1201 E Broadway Ste C
Monmouth, IL 61462-1995

Mailing address

PO Box 47
Bloomington, IL 61702-0047
Phone (309) 661-8823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295472017. Details of each certification follow.

  • CCN 146672 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 146672

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ADVANCED PHYSICAL THERAPY SERVICES, LTD
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Apr 24, 2001
Last certification
Jun 4, 2019
Ownership / control type
Proprietary
Facility address
1201 E Broadway, Ste C
Monmouth, IL 61462

National Provider Directory

National Provider Directory
Tax ID family
Advanced Physical Therapy10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1295472017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020047",
            "telephone_number": "309-661-8823",
            "fax_number": "309-661-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E BROADWAY STE C",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621995",
            "telephone_number": "309-734-1103",
            "fax_number": "309-734-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY SERVICES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "OERTWIG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "309-661-8823"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monmouth, IL

Sources for this page

Verify at the official NPI Registry.