Individual provider Active NPI

Parker Mitchell, PT, DPT

  • Physical Therapist
  • Olney, IL
National Provider Identifier
1497215289
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070021681 Issued in IL
Practice address
800 E Locust St
Olney, IL 62450-2553
Phone
(618) 395-6031
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070021681 IL Primary

Addresses

Primary practice location

800 E Locust St
Olney, IL 62450-2553

Mailing address

800 E Locust St
Olney, IL 62450-2553
Phone (618) 395-6031

Other practice location 1

500 S Scott Ave
Newton, IL 62448-1665
Phone (618) 783-2144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191209000803 IL Practitioner - Physical Therapist in Private Practice 2668805490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation and Performance Institute PSCGroup PAC ID 8729379888, 36 clinicians

Practice addresses (Care Compare)

332 Industrial Dr
Albion, IL 62806-1300
Phone (618) 445-7637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070021681ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation and Performance Institute PSC Physical Therapist CurrentSince Oct 14, 2019 Accepting new patients

Locations

332 Industrial Dr
Albion, IL 62806
Phone (618) 445-3669

1301 W Evergreen Ave
Ste 1A
Effingham, IL 62401
Phone (217) 690-4882

300 E Morgan St
Newton, IL 62448
Phone (217) 690-4882

108 E Main St
Olney, IL 62450
Phone (618) 445-3669

210 S 7th St
Petersburg, IL 62675
Phone (618) 852-3100

418 W 3rd St
Owensboro, KY 42301
Phone (270) 926-8145

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1497215289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E LOCUST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502553",
            "telephone_number": "618-395-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E LOCUST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502553",
            "telephone_number": "618-395-6031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Scott Ave",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "IL",
            "postal_code": "624481665",
            "country_code": "US",
            "telephone_number": "618-783-2144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PARKER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.