Sport Rehab, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPORT REHAB, INC.

Practice address

906 N Cedar St
Rolla, MO 65401-3350

Phone

(573) 368-0999

Fax

(573) 368-2777

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Marikay L Portell, MSPT/ATC

Title

Vice President

Phone

(573) 368-0999

Specialties & licenses 1

Addresses

Practitioners 3

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

• Casey J Robertson, ATC, LAT

  • Athletic Trainer
  • Rolla, MO
  • NPI 1720248750
  NPD
• Debra Kim Haberman, OTR

  • Hand Occupational Therapist
  • Rolla, MO
  • NPI 1093741431
  NPD (past)
• Scott Portell, DPT

  • Physical Therapist
  • Rolla, MO
  • NPI 1982653754
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1396794970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 N CEDAR ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013350",
            "telephone_number": "573-368-0999",
            "fax_number": "573-368-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N CEDAR ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013350",
            "telephone_number": "573-368-0999",
            "fax_number": "573-368-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "PORTELL",
        "authorized_official_first_name": "MARIKAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "573-368-0999",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSPT/ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Central Missouri Community Health Center
• James J Spadaro Jr., M.D.
• Emma Sparks, LMSW
• James Mark Spaw, FNP-C
• Christopher Ryan Spencer, M.D.
• Springfield Neurological and Spine Institute
• Luther D. Spurlock, MD
• SRZ Op Rolla LLC
• St. John'S Clinic Inc
• St. John'S Physicians & Clinics, Inc.

• Physical Therapist in Rolla, MO
• Providers in Rolla, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.