NPIMap

Organization Active NPI

SN Kentuckiana Rehab, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
National Provider Identifier
1669971123
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SN KENTUCKIANA REHAB, LLC
Practice address
410 N Hurstbourne Pkwy Ste 104
Louisville, KY 40222
Phone
(502) 426-2120
Fax
(502) 426-0362
NPI assigned
Feb 9, 2018
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Michael Tarvin
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

410 N Hurstbourne Pkwy Ste 104
Louisville, KY 40222

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Other practice location 1

2940 E Banner Gateway Dr Ste 425
Gilbert, AZ 85234-2177
Phone (480) 813-7900

Other names 1

  • KORT Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190326002841 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254671464 Receives reassigned benefits from 215 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, KY; Mt Washington, KY; Shelbyville, KY; Shepherdsville, KY; Taylorsville, KY; La Grange, KY; Elizabethtown, KY; Crestwood, KY

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory
Part of
Select Medical Corporation

Locations

2363 Highway 135 NW
Ste 117
Corydon, IN 47112
Phone (812) 734-1918

3121 E 10th St
Jeffersonvlle, IN 47130
Phone (812) 218-8039

3626 Grant Line Rd
New Albany, IN 47150
Phone (812) 944-1377

315 E Broadway
Ste 195C
Louisville, KY 40202

410 N Hurstbourne Pkwy
Ste 104
Louisville, KY 40222
Phone (502) 244-5044

1257 Goss Ave
Louisville, KY 40217
Phone (502) 635-0775

9300 Stonestreet Rd
Louisville, KY 40272
Phone (502) 935-8061

12101 Sycamore Station Pl
Ste 110
Louisville, KY 40299
Phone (502) 261-1950

Practitioners & affiliated clinicians

Practitioners 12

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": "1518134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1669971123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N HURSTBOURNE PKWY STE 104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-426-2120",
            "fax_number": "502-426-0362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 E Banner Gateway Dr Ste 425",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342177",
            "country_code": "US",
            "telephone_number": "480-813-7900",
            "fax_number": "480-813-7901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SN KENTUCKIANA REHAB, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2018-02-09",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KORT Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 6, 2019; 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.