Organization Active NPI

3C Therapy & Wellness

  • Physical Therapist
  • Princeton, IN
National Provider Identifier
1558029769
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
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 IDStateProvider typePAC IDDetails
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 Directory

Locations

210 E Broadway St
Princeton, IN 47670
Phone (812) 635-0600

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
300006117MedicaidIN

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.

Verify at the official NPI Registry.