NPIMap

Organization Active NPI

Physical Therapy Associates Inc

  • Physical Therapist
  • Brandenburg, KY
National Provider Identifier
1487001384
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY ASSOCIATES INC
Practice address
505 High Street
Brandenburg, KY 40108-1317
Phone
(270) 360-9129
Fax
(270) 234-8197
NPI assigned
May 20, 2016
Last updated
May 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Guy Wallace, PTNPI 1477605772
Title
Owner
Phone
(270) 360-9129

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

505 High Street
Brandenburg, KY 40108-1317

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

1222 Woodland Dr
Elizabethtown, KY 42701
Phone (270) 234-1569

141 Eastbrooke Pointe Dr E
Mt Washington, KY 40047
Phone (502) 251-5145

Practitioners & affiliated clinicians

Practitioners 3

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": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1487001384",
    "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",
            "fax_number": "270-234-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 HIGH STREET",
            "city": "BRANDENBURG",
            "state": "KY",
            "postal_code": "401081317",
            "telephone_number": "270-360-9129",
            "fax_number": "270-234-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "GUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-360-9129",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandenburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.