NPIMap

Organization Active NPI

Typaldos Physical Therapy and Rehabilitation Center Inc

Doing business as Physical Therapy Center

  • Physical Therapy Clinic/Center
  • Nixa, MO
National Provider Identifier
1336139989
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
TYPALDOS PHYSICAL THERAPY AND REHABILITATION CENTER INC
Doing business as
Physical Therapy Center
Practice address
1887 N State Highway CC
Nixa, MO 65714-8015
Phone
(417) 725-5774
Fax
(417) 725-5915
NPI assigned
Oct 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Authorized official

Name
John M Typaldos, PTNPI 1609866110
Title
President Administrator
Phone
(417) 725-5774

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1887 N State Highway CC
Nixa, MO 65714-8015

Mailing address

1887 N State Highway CC
Nixa, MO 65714-8015
Phone (417) 725-5774

Other identifiers 1

IdentifierTypeStateIssuer
576215701MedicaidMO

Other names 1

  • Physical Therapy Center Doing business as

National Provider Directory

National Provider Directory

Locations

1302 W Sunset St
Springfield, MO 65807
Phone (417) 725-5774

Practitioners & affiliated clinicians

Practitioners 1

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": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1336139989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 N STATE HIGHWAY CC",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148015",
            "telephone_number": "417-725-5774",
            "fax_number": "417-725-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 N STATE HIGHWAY CC",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148015",
            "telephone_number": "417-725-5774",
            "fax_number": "417-725-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYPALDOS PHYSICAL THERAPY AND REHABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "TYPALDOS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT ADMINISTRATOR",
        "authorized_official_telephone_number": "417-725-5774",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "576215701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nixa, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.