NPIMap

Organization Active NPI

Excel Physical Therapy, LLC

  • Physical Therapist
  • Jackson, WY
National Provider Identifier
1356414684
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EXCEL PHYSICAL THERAPY, LLC
Practice address
120 West Pearl Ave
Jackson, WY 83002
Phone
(307) 734-9129
NPI assigned
Nov 16, 2006
Last updated
Sep 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Authorized official

Name
Ms. Francine Bartlett, PT, ATCNPI 1063468270
Title
Partner
Phone
(307) 690-3180

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 Therapist 225100000X NU Primary

Addresses

Primary practice location

120 West Pearl Ave
Jackson, WY 83002

Mailing address

PO Box 8857
Jackson, WY 83002-8857
Phone (307) 734-2808

Other identifiers 1

IdentifierTypeStateIssuer
123646600MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070208000079 WY Part B Supplier - Clinic/Group Practice 0345242178 Receives reassigned benefits from 9 practitioners
Practice locations: Jackson, WY
O20241007003222 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345242178 Receives reassigned benefits from 3 practitioners
Practice locations: Driggs, ID

National Provider Directory

National Provider Directory
Tax ID family
Excel Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

39 W Little Ave
Ste 2
Driggs, ID 83422
Phone (307) 734-9129

4010 W Lake Creek Dr
Ste C
Wilson, WY 83014
Phone (307) 734-9129

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1356414684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8857",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830028857",
            "telephone_number": "307-734-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WEST PEARL AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83002",
            "telephone_number": "307-734-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "BARTLETT",
        "authorized_official_first_name": "FRANCINE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "307-690-3180",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123646600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.