Organization Active NPI

Holdrege Physical Therapy and Sports Rehab

  • Physical Therapist
  • Holdrege, NE
National Provider Identifier
1508586538
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
HOLDREGE PHYSICAL THERAPY AND SPORTS REHAB
Practice address
701 4TH Ave Ste 1
Holdrege, NE 68949-2255
Phone
(308) 248-0303
Fax
(308) 248-0304
NPI assigned
Aug 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Brandon Smith, DPTNPI 1780058693
Title
Physical Therapist
Phone
(308) 248-0303

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

701 4TH Ave Ste 1
Holdrege, NE 68949-2255

Mailing address

701 4TH Ave Ste 1
Holdrege, NE 68949-2255
Phone (308) 248-0303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220930001090 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4082090931 Receives reassigned benefits from 3 practitioners
Practice locations: Holdrege, NE

National Provider Directory

National Provider Directory

Locations

701 4th Ave
Holdrege, NE 68949

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": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1508586538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 4TH AVE STE 1",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689492255",
            "telephone_number": "308-248-0303",
            "fax_number": "308-248-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 4TH AVE STE 1",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689492255",
            "telephone_number": "308-248-0303",
            "fax_number": "308-248-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDREGE PHYSICAL THERAPY AND SPORTS REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "308-248-0303",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holdrege, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.