Physical Therapy, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHYSICAL THERAPY, LLC

Practice address

213 US Highway 60 W
Republic, MO 65738-1432

Phone

(417) 732-2344

Fax

(417) 732-6014

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Peterpaul Mayo Chanliongco, P.T.NPI 1982649125

Title

President

Phone

(417) 732-2344

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Republic Medical Supply & Republic Physical Therapy & Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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

• Peterpaul Mayo Chanliongco, PT

  • Physical Therapist
  • Republic, MO
  • NPI 1982649125
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1609965128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 US HIGHWAY 60 W",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657381432",
            "telephone_number": "417-732-2344",
            "fax_number": "417-732-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 US HIGHWAY 60 W",
            "city": "REPUBLIC",
            "state": "MO",
            "postal_code": "657381432",
            "telephone_number": "417-732-2344",
            "fax_number": "417-732-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "CHANLIONGCO",
        "authorized_official_first_name": "PETERPAUL",
        "authorized_official_middle_name": "MAYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-732-2344",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "100395",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "202177",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "610616900",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Republic Medical Supply & Republic Physical Therapy & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bailey Parker, SLP
• Amanda Kate Parsons, DPT
• Lawana Kay Patterson
• Cassi Lynn Pearce, CPM
• Victoria Percy
• Ida Piper
• Steven Place
• Rosanna Pogue
• Jaclyn Pohlers, DO
• Marcia L Preston, DDS

• Durable Medical Equipment & Medical Supplies in Republic, MO
• Providers in Republic, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.