NPIMap

Organization Active NPI

Five Star Rehabilitation and Wellness Services, LLC.

Doing business as Ageility Physical Therapy Solutions at Overland Park

  • Physical Therapy Clinic/Center
  • Overland Park, KS
National Provider Identifier
1447377015
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.
Doing business as
Ageility Physical Therapy Solutions at Overland Park
Practice address
6555 W 75TH St
Apt #3
Overland Park, KS 66204-3023
Phone
(913) 385-7307
Fax
(913) 385-7336
NPI assigned
Mar 26, 2007
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Jeffrey C Leer
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

6555 W 75TH St
Apt #3
Overland Park, KS 66204-3023

Mailing address

255 Washington St Ste 230
Newton, MA 02458-1644
Phone (617) 796-8350

Other names 1

  • Ageility Physical Therapy Solutions at Overland Park Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160111001019 KS Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0143323535 Practice locations: Lawrence, KS; Overland Park, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447377015. Details of each certification follow.

  • CCN 176570 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 176570

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
AGEILITY PHYSICAL THERAPY SOLUTIONS AT OVERLAND PA
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jun 11, 2007
Last certification
Nov 6, 2012
Ownership / control type
Proprietary
Facility address
6555 West 75TH Street Apt 3
Overland Park, KS 66204

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Five Star Rehabilitation and Wellness Services LLC7 organizations share this tax ID, including this one
Part of
Five Star Rehabilitation and Wellness Services LLC

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1447377015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 230",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581644",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 W 75TH ST",
            "address_2": "APT #3",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043023",
            "telephone_number": "913-385-7307",
            "fax_number": "913-385-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "enumeration_date": "2007-03-26",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "LEER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageility Physical Therapy Solutions at Overland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.