NPIMap

Organization Active NPI

South Arkansas Rehabilitation, Inc.

  • Physical Therapist
  • Monticello, AR
National Provider Identifier
1295882843
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTH ARKANSAS REHABILITATION, INC.
Practice address
1200 Old Warren Road
Monticello, AR 71655
Phone
(870) 367-1548
Fax
(870) 367-1383
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Authorized official

Name
Mr. Bryan Nathaniel Grubbs, PTNPI 1467554964
Title
Owner
Phone
(870) 367-1548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1200 Old Warren Road
Monticello, AR 71655

Mailing address

1200 Old Warren Road
Monticello, AR 71655
Phone (870) 367-1548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070314000349 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052414968 Receives reassigned benefits from 8 practitioners
Practice locations: MC Gehee, AR; Monticello, AR

National Provider Directory

National Provider Directory

Locations

1303 Highway 65 N
Mc Gehee, AR 71654
Phone (870) 367-1548

1200 Old Warren Rd
Monticello, AR 71655
Phone (870) 367-1548

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1295882843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OLD WARREN ROAD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-367-1548",
            "fax_number": "870-367-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD WARREN ROAD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-367-1548",
            "fax_number": "870-367-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "GRUBBS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "NATHANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-367-1548",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.