Premere Rehab LLC
Organization Active NPI Physical Therapist · Grand Junction, CO
NPI 1598030470 · NPPES record last updated Jan 2, 2013
Key facts
- NPI
- 1598030470
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- PREMERE REHAB LLC
- Practice address
- 2680 N 15TH St
Grand Junction, CO 81506-4101 - Phone
- (970) 245-7905
- NPI assigned
- Mar 12, 2012
- Organization subpart
- No
Authorized official
- Name
- Laura Cantrell
- Title
- Director of Outpatient
- Phone
- (360) 901-8111
Other NPIs on the same Medicare enrollment 20
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110321000981 | CO | Part B Supplier - Clinic/Group Practice | 2567434764 |
Receives reassigned benefits from 3 practitioners 20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Colorado Springs, CO; Denver, CO; Sterling, CO |
National Provider Directory
Locations
2680 N 15th St
Grand Junction, CO 81506
Phone (970) 241-9706
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
2680 N 15TH St
Grand Junction, CO 81506-4101
Mailing address
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| COA104421 | Other | CO | PTAN |
NPI Registry JSON
{
"created_epoch": "1331510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1357084800000",
"number": "1598030470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE STE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2680 N 15TH ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815064101",
"telephone_number": "970-245-7905"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMERE REHAB LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-12",
"last_updated": "2013-01-02",
"status": "A",
"authorized_official_last_name": "CANTRELL",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT",
"authorized_official_telephone_number": "360-901-8111"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "COA104421",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
- Pratt Chiropractic, LLC
- Lauren Michelle Pratt
- Preferred Homecare of Colorado, LLC
- Premere Rehab LLC
- Premere Rehab LLC
- Premere Rehab LLC
- Premier Healthcare Services, LLC
- Premier Healthcare Services, LLC
- Premier Home Health Inc.
- Stacy Lynn Prescott
All providers in Grand Junction, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.