Synergy Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-02548 Issued in KS

Legal business name

SYNERGY PHYSICAL THERAPY

Practice address

3425 W Central Ave
Wichita, KS 67203-4919

Phone

(316) 946-0990

Fax

(316) 943-1139

NPI assigned

Jul 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Charles Edward Lavacek, P.T.

Title

Owner/Physical Therapist

Phone

(316) 461-2321

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1538323324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034919",
            "telephone_number": "316-946-0990",
            "fax_number": "316-943-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034919",
            "telephone_number": "316-946-0990",
            "fax_number": "316-943-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "LAVACEK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "316-461-2321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-02548",
            "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 Jul 11, 2008; 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.