NPIMap

Organization Active NPI

Faith Rehab Healthcare, Inc.

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1366473282
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 5144 Issued in TN
Legal business name
FAITH REHAB HEALTHCARE, INC.
Practice address
1750 Madison Ave
Suite 120
Memphis, TN 38104-6492
Phone
(901) 725-2000
Fax
(901) 725-2002
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Fatima L Laquindanum, PTNPI 1861423782
Title
Administrator
Phone
(901) 725-2000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT 5144 TN Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT 103140 MO

Addresses

Primary practice location

1750 Madison Ave
Suite 120
Memphis, TN 38104-6492

Mailing address

1750 Madison Ave
Suite 120
Memphis, TN 38104-6492
Phone (901) 725-2000

Other identifiers 3

IdentifierTypeStateIssuer
3731466MedicaidTN
4115744OtherTNBCBS GROUP NUMBER
DE5742OtherTNMEDICARE RAILROAD NUMBER

Other names 1

  • NA Former legal business name

National Provider Directory

National Provider Directory

Locations

1750 Madison Ave
Ste 120
Memphis, TN 38104
Phone (901) 725-2000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366473282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 MADISON AVE",
            "address_2": "SUITE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046492",
            "telephone_number": "901-725-2000",
            "fax_number": "901-725-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 MADISON AVE",
            "address_2": "SUITE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046492",
            "telephone_number": "901-725-2000",
            "fax_number": "901-725-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH REHAB HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAQUINDANUM",
        "authorized_official_first_name": "FATIMA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-725-2000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT 5144",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "PT 103140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3731466",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "4115744",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD NUMBER",
            "identifier": "DE5742",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • 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.