NPIMap

Organization Active NPI

Physical Therapy Associates Inc

  • Physical Therapist
  • Hodgenville, KY
National Provider Identifier
1366658106
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
002884 Issued in KY
Legal business name
PHYSICAL THERAPY ASSOCIATES INC
Practice address
104 E Main St
Hodgenville, KY 42748-1316
Phone
(270) 358-9765
NPI assigned
May 16, 2007
Last updated
Oct 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Mr. Bradley Gordon Coffman
Title
Executive Director
Phone
(270) 360-9129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 002884 KY Primary

Addresses

Primary practice location

104 E Main St
Hodgenville, KY 42748-1316

Mailing address

403 N Miles St
Elizabethtown, KY 42701-1834
Phone (270) 360-9129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000469 KY Part B Supplier - Clinic/Group Practice 4880591270 Receives reassigned benefits from 18 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elizabethtown, KY; Radcliff, KY; Mt Washington, KY; Hodgenville, KY; Brandenburg, KY; Bardstown, KY

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy Associates Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

505 High St
Brandenburg, KY 40108
Phone (270) 360-9129

614 Westport Rd
Elizabethtown, KY 42701

104 E Main St
Hodgenville, KY 42748
Phone (270) 358-9765

632 S Lincoln Blvd
Hodgenville, KY 42748
Phone (270) 358-9765

490 W Lincoln Trail Blvd
Radcliff, KY 40160
Phone (270) 352-1061

Practitioners & affiliated clinicians

Practitioners 8

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": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1366658106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N MILES ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011834",
            "telephone_number": "270-360-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427481316",
            "telephone_number": "270-358-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-360-9129",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "002884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hodgenville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.