NPIMap

Organization Active NPI

Physical Therapy Advantage, P.C.

  • Physical Therapy Clinic/Center
  • North Aurora, IL
National Provider Identifier
1487700712
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PHYSICAL THERAPY ADVANTAGE, P.C.
Practice address
35 S Randall Rd
North Aurora, IL 60542-1585
Phone
(630) 892-8003
NPI assigned
Jan 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Authorized official

Name
Joseph Michael King, PT, ATCNPI 1831285238
Title
President
Phone
(630) 892-8003

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

35 S Randall Rd
North Aurora, IL 60542-1585

Mailing address

35 S Randall Rd
North Aurora, IL 60542-1585
Phone (630) 892-8003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070314000319 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2264535160 Receives reassigned benefits from 4 practitioners
Practice locations: North Aurora, IL

National Provider Directory

National Provider Directory

Locations

35 S Randall Rd
North Aurora, IL 60542
Phone (630) 892-8003

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1487700712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S RANDALL RD",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421585",
            "telephone_number": "630-892-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S RANDALL RD",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421585",
            "telephone_number": "630-892-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ADVANTAGE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-27",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-892-8003",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.