Phoenix Physical Therapy Rehab Ctr

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-006992-L Issued in PA

Legal business name

PHOENIX PHYSICAL THERAPY REHAB CTR

Practice address

4943 Germantown Ave
Philadelphia, PA 19144-5962

Phone

(215) 991-9911

Fax

(215) 991-9913

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Lauren Ashley PrewittNPI 1568938769

Title

Sole Owner

Phone

(215) 991-9911

Specialties & licenses 1

Addresses

Other identifiers 9

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Ashley Prewitt

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1568938769
  NPD (past) Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1558438754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26461",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191416461",
            "telephone_number": "215-991-9911",
            "fax_number": "215-991-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4943 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445962",
            "telephone_number": "215-991-9911",
            "fax_number": "215-991-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PHYSICAL THERAPY REHAB CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "PREWITT",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "215-991-9911"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-006992-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014008940001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2228304000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "690613",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "077743",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "35998",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "PHI54368",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0140089403",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "1543468",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3428119",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Miller Philp, MD
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• Anh T Phung, RPH
• Christopher Phung
• Khanh Phung

• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.