Organization Active NPI

Progressive Rehab Care, LLC

  • Physical Therapist
  • Lillington, NC
National Provider Identifier
1336127448
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROGRESSIVE REHAB CARE, LLC
Practice address
1901 N Main St
Lillington, NC 27546-6824
Phone
(910) 814-1555
Fax
(910) 814-1556
NPI assigned
Jan 9, 2006
Last updated
Jul 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Mr. Sanjay Khetarpal
Title
Member Manager
Phone
(910) 814-1555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1901 N Main St
Lillington, NC 27546-6824

Mailing address

PO Box 629
Mauldin, SC 29662-0629
Phone (910) 814-1555

Other identifiers 1

IdentifierTypeStateIssuer
7211831MedicaidNC

National Provider Directory

National Provider Directory

Locations

1901 N Main St
Lillington, NC 27546
Phone (910) 814-1555

1901 N Main St
Ste C
Lillington, NC 27546
Phone (910) 814-1555

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1336127448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296620629",
            "telephone_number": "910-814-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N MAIN ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275466824",
            "telephone_number": "910-814-1555",
            "fax_number": "910-814-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE REHAB CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "KHETARPAL",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "910-814-1555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211831",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.