NPIMap

Organization Active NPI

Advanced Physical Therapy Services, LTD.

Doing business as Advanced Rehab and Sports Medicine

  • Physical Therapist
  • Macomb, IL
National Provider Identifier
1336307115
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ADVANCED PHYSICAL THERAPY SERVICES, LTD.
Doing business as
Advanced Rehab and Sports Medicine
Practice address
130 S Lafayette St
Suite a
Macomb, IL 61455-2289
Phone
(309) 836-2500
Fax
(309) 836-2501
NPI assigned
May 28, 2008
Last updated
May 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED PHYSICAL THERAPY SERVICES, LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Authorized official

Name
Mr. Michael R SalawayNPI 1467450627
Title
President of Operations
Phone
(309) 661-8823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

130 S Lafayette St
Suite a
Macomb, IL 61455-2289

Mailing address

PO Box 5387
Bloomington, IL 61702-5387
Phone (309) 661-8823

Other names 1

  • Advanced Rehab and Sports Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061011000025 IL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9133101462 1 other NPI on this enrollment
Practice locations: Macomb, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336307115. Details of each certification follow.

  • CCN 146717 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 146717

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ADVANCED REHAB & SPORTS MEDICINE
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Nov 1, 2007
Last certification
Jan 11, 2023
Ownership / control type
Proprietary
Facility address
130 South Lafayette Street, Suite a
Macomb, IL 61455

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Advanced Physical Therapy10 organizations share this tax ID, including this one
Part of
Advanced Physical Therapy

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1336307115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5387",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617025387",
            "telephone_number": "309-661-8823",
            "fax_number": "309-661-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S LAFAYETTE ST",
            "address_2": "SUITE A",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552289",
            "telephone_number": "309-836-2500",
            "fax_number": "309-836-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY SERVICES, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED PHYSICAL THERAPY SERVICES, LTD.",
        "enumeration_date": "2008-05-28",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "SALAWAY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "309-661-8823",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Rehab and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macomb, IL

Sources for this page

Verify at the official NPI Registry.