NPIMap

Organization Active NPI

Exstrom Physical Therapy Inc

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1386776078
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EXSTROM PHYSICAL THERAPY INC
Practice address
3818 Normal Blvd
Lincoln, NE 68506
Phone
(402) 488-4282
Fax
(402) 488-6157
NPI assigned
Mar 9, 2007
Last updated
Jul 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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

Authorized official

Name
Denise Anne Exstrom Larsen, P.TNPI 1174661581
Title
President/Owner
Phone
(402) 488-4282

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 Primary

Addresses

Primary practice location

3818 Normal Blvd
Lincoln, NE 68506

Mailing address

3818 Normal Blvd
Lincoln, NE 68506
Phone (402) 488-4282

Other identifiers 2

IdentifierTypeStateIssuer
100249565-00MedicaidNE
10024956500MedicaidNE

National Provider Directory

National Provider Directory

Locations

3818 Normal Blvd
Lincoln, NE 68506
Phone (402) 488-4282

Practitioners & affiliated clinicians

Practitioners 11

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1386776078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 NORMAL BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68506",
            "telephone_number": "402-488-4282",
            "fax_number": "402-488-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 NORMAL BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68506",
            "telephone_number": "402-488-4282",
            "fax_number": "402-488-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXSTROM PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "EXSTROM LARSEN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "402-488-4282",
        "authorized_official_credential": "P.T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100249565-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024956500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.