NPIMap

Organization Active NPI

Madison Physical Therapy Services

  • Physical Therapist
  • Madison, AL
National Provider Identifier
1508879883
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH2852 Issued in AL
Legal business name
MADISON PHYSICAL THERAPY SERVICES
Practice address
7693 Highway 72 W
Madison, AL 35758-8750
Phone
(256) 325-3280
Fax
(256) 325-3281
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Authorized official

Name
Victor Dale Russell, R.P.T.NPI 1366455610
Title
President
Phone
(256) 325-3280

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PTH2852 AL Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PTH3369 AL
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PTH255 AL

Addresses

Primary practice location

7693 Highway 72 W
Madison, AL 35758-8750

Mailing address

7693 Highway 72 W
Madison, AL 35758-8750
Phone (256) 325-3280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050112000976 AL Part B Supplier - Clinic/Group Practice 2668421090 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, AL

National Provider Directory

National Provider Directory

Locations

7693 Highway 72 W
Madison, AL 35758
Phone (256) 325-3280

Practitioners & affiliated clinicians

Practitioners 2

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": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275955200000",
    "number": "1508879883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7693 HIGHWAY 72 W",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588750",
            "telephone_number": "256-325-3280",
            "fax_number": "256-325-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7693 HIGHWAY 72 W",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588750",
            "telephone_number": "256-325-3280",
            "fax_number": "256-325-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PHYSICAL THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2010-06-08",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-325-3280",
        "authorized_official_credential": "R.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2852",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3369",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.