Nicholas A Austin, MSPT, OCS

Individual provider Active NPI Physical Therapist · Lagrange, KY

NPI 1649320250 · NPPES record last updated Mar 8, 2017

Key facts

NPI
1649320250
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
004132 (KY)
Practice address
214 Parker Dr
Suite B
Lagrange, KY 40031-1200
Phone
(502) 222-0280
Fax
(502) 222-0290
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prorehab Louisville (71 clinicians)

Practice addresses (Care Compare)

3630 Brownsboro Rd
Louisville, KY 40207-1861
Phone (502) 749-6950

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080429000867 KY Practitioner - Physical Therapist in Private Practice 4587743703 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
004132KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prorehab Louisville Physical Therapist Current
since Feb 1, 2015
Accepting new patients
Prorehab Louisville, LLC Physical Therapist Current
since Feb 1, 2015
Accepting new patients
Prorehab Louisville Physical Therapist Current Accepting new patients
Apex Physical Therapy and Rehabilitation, PLLC Physical Therapist Past Accepting new patients

Locations

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

175 S English Station Rd
Ste 220
Louisville, KY 40245
Phone (502) 245-1136

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

169 S English Station Rd
Louisville, KY 40245
Phone (502) 245-1136

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 004132 KY
Physical Therapist 225100000X 004132 KY Yes

Addresses

Primary practice location

214 Parker Dr
Suite B
Lagrange, KY 40031-1200

Mailing address

13415 Forest Springs Dr
Louisville, KY 40245-2077
Phone (502) 742-4825

Other identifiers

IdentifierTypeStateIssuer
000000484221OtherKYANTHEM PROVIDER ID
000000946564OtherKYBLUE CROSS BLUE SHIELD
4132OtherKYKY STATE LICENSE
9514OtherKYOCS CERTIFICATION
7100392180MedicaidKY

Other providers in Lagrange, KY

All providers in Lagrange, KY · Physical Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.