Organization Active NPI

The Pelvic Physio

  • Physical Therapy Clinic/Center
  • Omaha, NE
National Provider Identifier
1649851072
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
THE PELVIC PHYSIO
Practice address
2806 S 110TH CT
Omaha, NE 68144-4814
Phone
(218) 779-7485
Fax
(402) 819-0916
NPI assigned
Apr 17, 2021
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Kayla IvesNPI 1346648615
Title
Owner/Physical Therapist
Phone
(218) 779-7485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2806 S 110TH CT
Omaha, NE 68144-4814

Mailing address

2806 S 110TH CT
Omaha, NE 68144-4814
Phone (402) 502-8374

Other identifiers 3

IdentifierTypeStateIssuer
1265913214MedicaidNE
1144461583MedicaidNE
1215672233MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241014001806 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1658803895 Receives reassigned benefits from 9 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

2806 S 110th Ct
Omaha, NE 68144
Phone (402) 502-8374

2909 S 169th Plz
Ste 120
Omaha, NE 68130
Phone (218) 779-7485

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1649851072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 S 110TH CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444814",
            "telephone_number": "402-502-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 S 110TH CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444814",
            "telephone_number": "218-779-7485",
            "fax_number": "402-819-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PELVIC PHYSIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-17",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "IVES",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "218-779-7485"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265913214",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144461583",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215672233",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.