Advance Hannibal Regional Hospital, LLC
Organization Active NPI Physical Therapist · Bowling Green, MO
NPI 1609112754 · NPPES record last updated Jan 23, 2024
Key facts
- NPI
- 1609112754
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- ADVANCE HANNIBAL REGIONAL HOSPITAL, LLC
- Practice address
- 710 Bus. Hwy 61 South
Bowling Green, MO 63334 - Phone
- (573) 324-6079
- Fax
- (573) 221-1808
- NPI assigned
- Dec 18, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Gregory Reis, P.T.
- Title
- Partner
- Phone
- (217) 222-6800
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 6
Practitioners 2
-
Jailynn Nicole Francisco, D.P.T
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131021000862 | MO | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 6709022122 |
Receives reassigned benefits from 30 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bowling Green, MO; Canton, MO; Hannibal, MO; Kirksville, MO; Monroe City, MO; Palmyra, MO; Troy, MO |
National Provider Directory
- Tax ID family
- Advance Hannibal Regional Hospital LLC
Locations
710 S Business Highway 61
Bowling Green, MO 63334
Phone (573) 324-2063
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
710 Bus. Hwy 61 South
Bowling Green, MO 63334
Mailing address
160 Progress Rd Ste 111
Hannibal, MO 63401-6630
Phone (573) 324-6079
Other providers in Bowling Green, MO
- Agency a Wellness Center
- Hanna Jane Allen
- Cynthia Anders
- Anita J. Huber, DC
- Angela R Barton-Scherder
All providers in Bowling Green, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2024. 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.