Industrial and Sports Rehab, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

INDUSTRIAL AND SPORTS REHAB, LLC

Practice address

4415 W Zoo Blvd
Wichita, KS 67212-1601

Phone

(316) 943-6282

Fax

(316) 943-6189

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Kelly Sampson

Title

Administrative Manager

Phone

(316) 946-0086

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508993692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 W ZOO BLVD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672121601",
            "telephone_number": "316-943-6282",
            "fax_number": "316-943-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 W ZOO BLVD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672121601",
            "telephone_number": "316-943-6282",
            "fax_number": "316-943-6189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL AND SPORTS REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATIVE MANAGER",
        "authorized_official_telephone_number": "316-946-0086"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.