NPIMap

Organization Active NPI

Valentine Physical Therapy and Sports Rehab, LLC.

  • Physical Therapy Clinic/Center
  • Valentine, NE
National Provider Identifier
1487940698
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2861 Issued in NE
Legal business name
VALENTINE PHYSICAL THERAPY AND SPORTS REHAB, LLC.
Practice address
130 W 4TH St
Valentine, NE 69201-1830
Phone
(402) 376-1140
Fax
(402) 376-1140
NPI assigned
Jun 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Lanell Mae Graham, D.P.T.NPI 1265728943
Title
Physical Therapist
Phone
(402) 340-6501

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 2861 NE Primary

Addresses

Primary practice location

130 W 4TH St
Valentine, NE 69201-1830

Mailing address

130 W 4TH St
Valentine, NE 69201-1830
Phone (402) 376-1140

Other identifiers 1

IdentifierTypeStateIssuer
10026179000MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161111000143 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9739352634 Receives reassigned benefits from 1 practitioner
Practice locations: Valentine, NE

National Provider Directory

National Provider Directory

Locations

132 S Hall St
Valentine, NE 69201
Phone (402) 376-1140

148 E 1st St
Ste 100
Valentine, NE 69201
Phone (402) 376-1140

Practitioners & affiliated clinicians

Practitioners 3

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": "1309046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487940698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W 4TH ST",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692011830",
            "telephone_number": "402-376-1140",
            "fax_number": "402-376-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W 4TH ST",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692011830",
            "telephone_number": "402-376-1140",
            "fax_number": "402-376-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENTINE PHYSICAL THERAPY AND SPORTS REHAB, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "LANELL",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "402-340-6501",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NE",
            "license": "2861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026179000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valentine, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.