NPIMap

Organization Active NPI

Impact Rehabilitation and Sports Medicine, Inc.

  • Orthopedic Physical Therapist
  • Calera, AL
National Provider Identifier
1497861926
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 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
Last updated
Apr 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Authorized official

Name
Michael Chadwick
Title
Owner
Phone
(205) 621-3077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497861926. Details of each certification follow.

  • CCN 016591 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 016591

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
IMPACT REHABILITATION AND SPORTS MEDICINE, INC.
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Mar 13, 2003
Last certification
Jan 12, 2022
Ownership / control type
Proprietary
Facility address
101 Carrington Lane, Suite C
Calera, AL 35040

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calera, AL

Sources for this page

Verify at the official NPI Registry.