Individual provider Active NPI

Jason P Walsh, DPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1629309521
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
8019 Dixie Hwy Ste 106
Louisville, KY 40258-1303
Phone
(502) 500-6970
Fax
(502) 200-6973
NPI assigned
Jan 18, 2010
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

8019 Dixie Hwy Ste 106
Louisville, KY 40258-1303

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other practice location 1

1010 Executive Dr
Suite 250
Westmont, IL 60559-6135
Phone (630) 655-8785

Other identifiers 1

IdentifierTypeStateIssuer
P01055750OtherILMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170711002197 KY Practitioner - Physical Therapist in Private Practice 9830386747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Northwestern University Feinberg Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prorehab LouisvilleGroup PAC ID 4587981337, 71 clinicians

Practice addresses (Care Compare)

3052 Bardstown Rd
Louisville, KY 40205-3020
Phone (502) 454-5544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prorehab Louisville, LLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Prorehab Louisville Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Prorehab Louisville Physical Therapist Current Accepting new patients

Locations

1407 E Crystal Dr
Ste E
Lagrange, KY 40031
Phone (502) 222-0280

3052 Bardstown Rd
Louisville, KY 40205
Phone (502) 454-5544

3630 Brownsboro Rd
Louisville, KY 40207
Phone (502) 749-6950

8019 Dixie Hwy
Ste 106
Louisville, KY 40258
Phone (502) 200-6970

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629309521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 DIXIE HWY STE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581303",
            "telephone_number": "502-500-6970",
            "fax_number": "502-200-6973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Executive Dr",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605596135",
            "country_code": "US",
            "telephone_number": "630-655-8785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JASON",
        "middle_name": "P",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01055750",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.