Physical Therapy in Motion PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1177 Issued in NE

Legal business name

PHYSICAL THERAPY IN MOTION PC

Practice address

10020 Nicholas St
Suite 105
Omaha, NE 68114-2189

Phone

(402) 926-4088

Fax

(402) 926-4197

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Domerlin U. Sodusta, PT, MBA

Title

President & Ceo

Phone

(402) 926-4088

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346463700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 NICHOLAS ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142189",
            "telephone_number": "402-926-4088",
            "fax_number": "402-926-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 NICHOLAS ST",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142189",
            "telephone_number": "402-926-4088",
            "fax_number": "402-926-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY IN MOTION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SODUSTA",
        "authorized_official_first_name": "DOMERLIN",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "402-926-4088",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.