Organization Active NPI

Elite Physical Therapy & Wellness, LLC

  • Physical Therapist
  • Scottsbluff, NE
National Provider Identifier
1609149483
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2843 Issued in NE
Legal business name
ELITE PHYSICAL THERAPY & WELLNESS, LLC
Practice address
214 W 27TH St
Scottsbluff, NE 69361-4306
Phone
(308) 633-2900
Fax
(308) 575-0334
NPI assigned
Feb 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Dr. Katie Hays, DPT
Title
Owner
Phone
(308) 633-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 2843 NE Primary

Addresses

Primary practice location

214 W 27TH St
Scottsbluff, NE 69361-4306

Mailing address

214 W 27TH St
Scottsbluff, NE 69361-4306
Phone (308) 633-2900

Other identifiers 1

IdentifierTypeStateIssuer
10026150800MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120222000948 NE Part B Supplier - Clinic/Group Practice 9830357870 Receives reassigned benefits from 3 practitioners
Practice locations: Gering, NE; Scottsbluff, NE

National Provider Directory

National Provider Directory

Locations

1320 10th St
Ste 1
Gering, NE 69341

1270 10th St
Ste 101
Gering, NE 69341
Phone (308) 633-4440

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1609149483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W 27TH ST",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614306",
            "telephone_number": "308-633-2900",
            "fax_number": "308-575-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W 27TH ST",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614306",
            "telephone_number": "308-633-2900",
            "fax_number": "308-575-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PHYSICAL THERAPY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "HAYS",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-633-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026150800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.