NPIMap

Organization Active NPI

Advanced Therapy & Sports Med., LLC

Doing business as Advanced Therapy & Sports Medicine

  • Physical Therapy Clinic/Center
  • Great Bend, KS
National Provider Identifier
1679036206
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ADVANCED THERAPY & SPORTS MED., LLC
Doing business as
Advanced Therapy & Sports Medicine
Practice address
4801 10TH St
Great Bend, KS 67530-3252
Phone
(620) 792-7868
Fax
(620) 792-7867
NPI assigned
Apr 10, 2019
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Kevyn Soupiset, PTNPI 1932110863
Title
Owner
Phone
(620) 792-7868

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

4801 10TH St
Great Bend, KS 67530-3252

Mailing address

4801 10TH St
Great Bend, KS 67530-3252
Phone (620) 792-7868

Other practice location 1

2209 Canterbury Dr
Hays, KS 67601-2276
Phone (785) 621-4570

Other practice location 2

117 W 6th St
Larned, KS 67550-3045
Phone (620) 285-6011

Other names 1

  • Advanced Therapy & Sports Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190517000153 KS Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6204179153 Practice locations: Great Bend, KS; Hays, KS; Larned, KS

National Provider Directory

National Provider Directory

Locations

4801 10th St
Great Bend, KS 67530
Phone (620) 603-4421

Practitioners & affiliated clinicians

Practitioners 5

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": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1679036206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 10TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303252",
            "telephone_number": "620-792-7868",
            "fax_number": "620-792-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 10TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303252",
            "telephone_number": "620-792-7868",
            "fax_number": "620-792-7867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 Canterbury Dr",
            "address_purpose": "LOCATION",
            "city": "Hays",
            "state": "KS",
            "postal_code": "676012276",
            "country_code": "US",
            "telephone_number": "785-621-4570",
            "fax_number": "785-621-4571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 W 6th St",
            "address_purpose": "LOCATION",
            "city": "Larned",
            "state": "KS",
            "postal_code": "675503045",
            "country_code": "US",
            "telephone_number": "620-285-6011",
            "fax_number": "620-285-6012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED THERAPY & SPORTS MED., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "SOUPISET",
        "authorized_official_first_name": "KEVYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-792-7868",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Therapy & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.