NPIMap

Organization Active NPI

BHSM Rehabilitation, LLC

Doing business as Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Flagstaff, AZ
National Provider Identifier
1588330898
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BHSM REHABILITATION, LLC
Doing business as
Banner Physical Therapy
Practice address
906 W University Ave Ste 120
Flagstaff, AZ 86001-7115
Phone
(928) 556-9935
NPI assigned
Aug 17, 2021
Last updated
Oct 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Authorized official

Name
Elizabeth Gelbaugh
Title
Manager of Regulatory Affairs
Phone
(717) 975-4510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

906 W University Ave Ste 120
Flagstaff, AZ 86001-7115

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Other names 1

  • Banner Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180306002185 AZ Part B Supplier - Clinic/Group Practice 2062773138 Receives reassigned benefits from 345 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Queen Creek, AZ; Scottsdale, AZ; Tempe, AZ; Tucson, AZ; Mesa, AZ; Peoria, AZ; Buckeye, AZ…

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Champion Sports Medicine6 organizations share this tax ID, including this one
Part of
Select Medical Corporation

Other organizations with this tax ID 5

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

Locations

201 Doug Baker Blvd
Hoover, AL 35242
Phone (205) 408-0700

Practitioners & affiliated clinicians

Practitioners 1

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": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1588330898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W UNIVERSITY AVE STE 120",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017115",
            "telephone_number": "928-556-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHSM REHABILITATION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL CORPORATION",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "GELBAUGH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGER OF REGULATORY AFFAIRS",
        "authorized_official_telephone_number": "717-975-4510"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.