Organization Active NPI

Paradox Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Wayne, NE
National Provider Identifier
1609611680
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PARADOX PHYSICAL THERAPY, LLC
Practice address
118 W 3Rd St
Wayne, NE 68787-1915
Phone
(402) 369-2773
NPI assigned
Jul 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Gail B McCorkindale, PTNPI 1982962635
Title
Physical Therapist
Phone
(402) 833-8479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

118 W 3Rd St
Wayne, NE 68787-1915

Mailing address

1700 Claycomb Rd
Wayne, NE 68787-1238
Phone (402) 833-8479

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241029001787 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345773388 Receives reassigned benefits from 1 practitioner
Practice locations: Wayne, NE

National Provider Directory

National Provider Directory

Locations

118 W 3rd St
Wayne, NE 68787
Phone (402) 369-2773

Practitioners & affiliated clinicians

Practitioners 1

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": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1609611680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CLAYCOMB RD",
            "city": "WAYNE",
            "state": "NE",
            "postal_code": "687871238",
            "telephone_number": "402-833-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W 3RD ST",
            "city": "WAYNE",
            "state": "NE",
            "postal_code": "687871915",
            "telephone_number": "402-369-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADOX PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-30",
        "status": "A",
        "authorized_official_last_name": "MCCORKINDALE",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "402-833-8479",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.