Active NPI
Advanced PT, LLC
- Physical Therapist
- Sterling, KS
National Provider Identifier
1629301155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-02726
- Legal business name
- ADVANCED PT, LLC
- Practice address
- 239 N Broadway Ave
Sterling, KS 67579-1916 - Phone
- (620) 204-6116
- Fax
- (620) 204-6116
- NPI assigned
- Sep 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David C Todd, PT
- Title
- Owner
- Phone
- (316) 260-6869
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-02726 | KS | Primary |
Addresses
Primary practice location
239 N Broadway Ave
Sterling, KS 67579-1916
Mailing address
200 W Douglas Ave
Ste. 1040
Wichita, KS 67202-3013
Phone (316) 263-0003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100412740D | Medicaid | KS |
Other names 1
- Preferred PT Sterling
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060222000723 | KS | Part B Supplier - Clinic/Group Practice | 3678524709 |
Receives reassigned benefits from 102 practitioners 27 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Arkansas City, KS; Andover, KS; Winfield, KS; Wichita, KS; Wellington, KS; Sterling, KS; Park City, KS; Newton, KS… |
Other NPIs on the same Medicare enrollment 27
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Lenexa, KS
- NPI 1609255124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253059200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1253059200000",
"number": "1629301155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W DOUGLAS AVE",
"address_2": "STE. 1040",
"city": "WICHITA",
"state": "KS",
"postal_code": "672023013",
"telephone_number": "316-263-0003",
"fax_number": "316-263-1241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 N BROADWAY AVE",
"city": "STERLING",
"state": "KS",
"postal_code": "675791916",
"telephone_number": "620-204-6116",
"fax_number": "620-204-6116"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED PT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-09-16",
"last_updated": "2009-09-16",
"status": "A",
"authorized_official_last_name": "TODD",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "316-260-6869",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-02726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100412740D",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Preferred PT Sterling",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sterling, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.