Active NPI
3C Therapy & Wellness
- Physical Therapist
- Princeton, IN
National Provider Identifier
1558029769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- 3C THERAPY & WELLNESS
- Practice address
- 220 N Hart St
Princeton, IN 47670-1534 - Phone
- (812) 635-0600
- Fax
- (812) 635-0601
- NPI assigned
- Dec 5, 2021
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Beth Davis
- Title
- Office Manager
- Phone
- (270) 225-0439
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220216000850 | IN | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2163815168 |
Receives reassigned benefits from 1 practitioner Practice locations: Princeton, IN |
National Provider Directory
National Provider DirectoryLocations
210 E Broadway St
Princeton, IN 47670
Phone (812) 635-0600
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
220 N Hart St
Princeton, IN 47670-1534
Mailing address
220 N Hart St
Princeton, IN 47670-1534
Phone (812) 635-0600
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300006117 | Medicaid | IN |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 5, 2021.
{
"created_epoch": "1638662400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638662400000",
"number": "1558029769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 N HART ST",
"city": "PRINCETON",
"state": "IN",
"postal_code": "476701534",
"telephone_number": "812-635-0600",
"fax_number": "812-635-0601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 N HART ST",
"city": "PRINCETON",
"state": "IN",
"postal_code": "476701534",
"telephone_number": "812-635-0600",
"fax_number": "812-635-0601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "3C THERAPY & WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2021-12-05",
"last_updated": "2021-12-05",
"certification_date": "2021-12-05",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "BETH",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "270-225-0439"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300006117",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Princeton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2021; 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.