Organization Active NPI

Premier Physical Therapy

  • Physical Therapy Clinic/Center
  • Elko, NV
National Provider Identifier
1649237876
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1463 Issued in NV
Legal business name
PREMIER PHYSICAL THERAPY
Practice address
2213 North 5TH Steet
Suite B
Elko, NV 89801-2471
Phone
(775) 777-0901
Fax
(775) 777-0923
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Mr. Marc Patten Grow, P.T.
Title
Physical Therapist / Owner
Phone
(775) 777-0901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1463 NV Primary

Addresses

Primary practice location

2213 North 5TH Steet
Suite B
Elko, NV 89801-2471

Mailing address

2213 North 5TH Steet
Suite B
Elko, NV 89801-2471
Phone (775) 777-0901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050302000271 NV Part B Supplier - Clinic/Group Practice 3870546831 Receives reassigned benefits from 1 practitioner
Practice locations: Elko, NV

National Provider Directory

National Provider Directory

Locations

2213 N 5th St
Ste B
Elko, NV 89801
Phone (775) 322-1200

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": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1649237876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 NORTH 5TH STEET",
            "address_2": "SUITE B",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012471",
            "telephone_number": "775-777-0901",
            "fax_number": "775-777-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 NORTH 5TH STEET",
            "address_2": "SUITE B",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012471",
            "telephone_number": "775-777-0901",
            "fax_number": "775-777-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "GROW",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "PATTEN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "775-777-0901",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NV",
            "license": "1463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.