Impact Rehabilitation and Sports Medicine, Inc.
Organization Active NPI Orthopedic Physical Therapist · Calera, AL
NPI 1497861926 · NPPES record last updated Apr 22, 2009
Key facts
- NPI
- 1497861926
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- Legal business name
- IMPACT REHABILITATION AND SPORTS MEDICINE, INC.
- Practice address
- 101 Carrington LN Ste C
Calera, AL 35040-5439 - Phone
- (205) 621-3077
- Fax
- (205) 621-3788
- NPI assigned
- Aug 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Michael Chadwick
- Title
- Owner
- Phone
- (205) 621-3077
Practitioners 6
-
Kathleen Hall Kinne, DPT
-
Cynthia Bell Matthews, MSPT
-
Beth Gardner Nicholson, OTR, CHT
-
Heather Hines Ray, D.P.T.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist |
2251X0800X | Yes |
Addresses
Primary practice location
101 Carrington LN Ste C
Calera, AL 35040-5439
Mailing address
PO Box 1694
Calera, AL 35040-1694
Phone (205) 621-3077
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50727 | Other | AL | HEALTH SPRING |
| 51534667 | Other | AL | CHRISTY BCBS |
| 438219695 | Other | AL | TRI-CARE |
| 51535738 | Other | AL | SUZI BCBS |
| AETNA | Other | AL | 7176438 |
NPI Registry JSON
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240358400000",
"number": "1497861926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1694",
"city": "CALERA",
"state": "AL",
"postal_code": "350401694",
"telephone_number": "205-621-3077",
"fax_number": "205-621-3788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CARRINGTON LN STE C",
"city": "CALERA",
"state": "AL",
"postal_code": "350405439",
"telephone_number": "205-621-3077",
"fax_number": "205-621-3788"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMPACT REHABILITATION AND SPORTS MEDICINE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-21",
"last_updated": "2009-04-22",
"status": "A",
"authorized_official_last_name": "CHADWICK",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "205-621-3077"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH SPRING",
"identifier": "50727",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHRISTY BCBS",
"identifier": "51534667",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRI-CARE",
"identifier": "438219695",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUZI BCBS",
"identifier": "51535738",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "7176438",
"identifier": "AETNA",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calera, AL
- Courtney Kiana Harris
- Megan Hepler
- Gary L. Howard
- Kennedy Howard
- Talisia Zhanea Howard
- Initiative Counseling, LLC
- Inspired Medical, Incorporated
- Kelsey C Jacks
- Lucinda Jackson
- Ja'Nisa Latoya Joe
All providers in Calera, AL · Orthopedic Physical Therapist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.