NPIMap

Organization Active NPI

Prorehab, Inc

  • Durable Medical Equipment & Medical Supplies
  • Boonville, IN
National Provider Identifier
1578083432
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROREHAB, INC
Practice address
3070 Warrick Dr
Boonville, IN 47601-9658
Phone
(812) 641-0076
Fax
(812) 641-0268
NPI assigned
Jun 22, 2017
Last updated
Apr 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Patrick D Wempe, DPTNPI 1255315420
Title
Ceo/Owner
Phone
(812) 476-0409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Occupational Medicine Clinic/Center 261QX0100X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

3070 Warrick Dr
Boonville, IN 47601-9658

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (316) 223-4951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170824001271 IN DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 1254317217 Practice locations: Boonville, IN

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Laura M Happe TR19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

3070 Warrick Dr
Boonville, IN 47601
Phone (812) 431-0517

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1578083432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "316-223-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 WARRICK DR",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476019658",
            "telephone_number": "812-641-0076",
            "fax_number": "812-641-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "WEMPE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "812-476-0409",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.