NPIMap

Organization Active NPI

SN Kentuckiana Rehab, LLC

Doing business as KORT Physical Therapy

  • Rehabilitation Clinic/Center
  • Louisville, KY
National Provider Identifier
1306319710
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SN KENTUCKIANA REHAB, LLC
Doing business as
KORT Physical Therapy
Practice address
4420 Dixie Hwy Ste 122
Louisville, KY 40216-2986
Phone
(502) 447-2750
Fax
(502) 449-9062
NPI assigned
Jan 8, 2019
Last updated
Feb 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Michael Tarvin
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

4420 Dixie Hwy Ste 122
Louisville, KY 40216-2986

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Other names 1

  • KORT Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190326002841 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254671464 Receives reassigned benefits from 215 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY; Mt Washington, KY; Shelbyville, KY; Shepherdsville, KY; Taylorsville, KY; La Grange, KY; Elizabethtown, KY; Crestwood, KY

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory
Part of
Select Medical Corporation

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12000 Aiken Rd
Louisville, KY 40243
Phone (502) 489-5002

2152 S Hurstbourne Pkwy
Louisville, KY 40220
Phone (502) 349-6961

2901 Bardstown Rd
Louisville, KY 40205
Phone (502) 459-6307

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1306319710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 DIXIE HWY STE 122",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162986",
            "telephone_number": "502-447-2750",
            "fax_number": "502-449-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SN KENTUCKIANA REHAB, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KORT Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KORT Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.