Mountaincrest Rehab of Lowell

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MOUNTAINCREST REHAB OF LOWELL

Practice address

212 S Lincoln St
Suite D
Lowell, AR 72745

Phone

(479) 770-5655

Fax

(479) 770-5656

NPI assigned

May 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joel Damarillo Sebag, PTNPI 1164405395

Title

President

Phone

(870) 743-5573

Specialties & licenses 1

Addresses

Locations

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.

• Joel Damarillo Sebag, RPT

  • Physical Therapist
  • Harrison, AR
  • NPI 1164405395
  Authorized official Same address or phone

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609829449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726020841",
            "telephone_number": "870-743-5573",
            "fax_number": "870-743-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S LINCOLN ST",
            "address_2": "SUITE D",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "72745",
            "telephone_number": "479-770-5655",
            "fax_number": "479-770-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINCREST REHAB OF LOWELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEBAG",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "DAMARILLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-743-5573",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Lowell, AR
• Providers in Lowell, AR by specialty
• Physical Therapy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.