NPIMap

Organization Active NPI

Physical Therapy Institute

  • Physical Therapy Clinic/Center
  • Little Rock, AR
National Provider Identifier
1497077648
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PHYSICAL THERAPY INSTITUTE
Practice address
1909 Hinson Loop Rd Ste 100
Little Rock, AR 72212-3903
Phone
(501) 301-4530
Fax
(501) 251-1165
NPI assigned
Feb 15, 2010
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Mr. Derek Alan Lagemann, PT, DPT, FAAOMPTNPI 1104860956
Title
Co - Owner
Phone
(501) 804-3558

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 NU Primary

Addresses

Primary practice location

1909 Hinson Loop Rd Ste 100
Little Rock, AR 72212-3903

Mailing address

PO Box 241574
Little Rock, AR 72223-0011
Phone (501) 804-3558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110210001153 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214117001 Receives reassigned benefits from 32 practitioners
Practice locations: Sherwood, AR; Maumelle, AR; Little Rock, AR; Benton, AR; Conway, AR

National Provider Directory

National Provider Directory

Locations

221 N East St
Benton, AR 72015
Phone (501) 301-4350

3505 Boone Rd
Benton, AR 72015
Phone (501) 315-1555

3310 W Main St
Cabot, AR 72023
Phone (501) 259-8337

10901 N Rodney Parham Rd
Ste 7A
Little Rock, AR 72212

1909 Hinson Loop Rd
Ste 100
Little Rock, AR 72212
Phone (501) 563-9412

100 Commerce Dr
Maumelle, AR 72113
Phone (501) 803-9722

223 Country Club Pkwy
Maumelle, AR 72113

4199 E Kiehl Ave
Sherwood, AR 72120

7507 Warden Rd
Sherwood, AR 72120

9880 Brockington Rd
Apt 147
Sherwood, AR 72120
Phone (501) 944-7819

9880 Brockington Rd
Ste 147
Sherwood, AR 72120
Phone (501) 912-7699

Practitioners & affiliated clinicians

Practitioners 54

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.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1497077648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241574",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230011",
            "telephone_number": "501-804-3558",
            "fax_number": "501-251-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 HINSON LOOP RD STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123903",
            "telephone_number": "501-301-4530",
            "fax_number": "501-251-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-15",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "LAGEMANN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CO - OWNER",
        "authorized_official_telephone_number": "501-804-3558",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, DPT, FAAOMPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.