Chet E Clodfelter, P.T.

Individual provider Active NPI Physical Therapist · Greencastle, IN

NPI 1306911292 · NPPES record last updated Apr 20, 2017

Key facts

NPI
1306911292
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
05002491A (IN)
Practice address
1003 Mill Pond LN Ste C
Greencastle, IN 46135-2609
Phone
(765) 653-8494
Fax
(765) 653-7835
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTD (2,187 clinicians)

Practice addresses (Care Compare)

1155 S College Mall Rd
Suite a
Bloomington, IN 47401-6166
Phone (812) 558-3356

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100 (group)
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100120000270 IN Practitioner - Physical Therapist in Private Practice 7416099098 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
05002491AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist Current
since Feb 10, 2020
Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients
Athletico, LTD Physical Therapist Current
since Feb 10, 2020
Accepting new patients
Central Indiana Rehabilitative Services Inc Physical Therapist Past
since Nov 1, 1994
Accepting new patients

Locations

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

1155 S College Mall Rd
Ste A
Bloomington, IN 47401
Phone (812) 558-3356

3229 Broadway
Gary, IN 46409
Phone (219) 326-2324

1003 Mill Pond Dr
Ste C
Greencastle, IN 46135
Phone (765) 653-8494

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05002491A IN Yes

Addresses

Primary practice location

1003 Mill Pond LN Ste C
Greencastle, IN 46135-2609

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980

Other identifiers

IdentifierTypeStateIssuer
100211050MedicaidIN

Other providers in Greencastle, IN

All providers in Greencastle, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.