Bespoke Rehabilitation, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BESPOKE REHABILITATION, LLC

Practice address

5015 Rustic Oak Dr
Longview, TX 75604-8202

Phone

(432) 258-8673

NPI assigned

May 24, 2024

Last updated

Dec 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jimmy A Chamberlain, OTRNPI 1275928228

Title

Ceo/Occupational Therapist

Phone

(903) 445-4064

Specialties & licenses 2

Addresses

Other names 1

• Bespoke Rehabilitation Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 3

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.

• Jimmy Alphonse Chamberlain

  • Occupational Therapist
  • Longview, TX
  • NPI 1275928228
  Medicare reassignment Care Compare group NPD Authorized official
• Sheryl Pineda, PT

  • Physical Therapist
  • Longview, TX
  • NPI 1821459561
  Medicare reassignment Care Compare group NPD
• Mallory Powell, COTA

  • Occupational Therapy Assistant
  • Longview, TX
  • NPI 1053275271
  NPD

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1679312011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 RUSTIC OAK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756048202",
            "telephone_number": "432-258-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 RUSTIC OAK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756048202",
            "telephone_number": "432-258-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "903-445-4064",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bespoke Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bespoke Rehabilitation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• George Albert Berry Jr., D.C.
• Jody David Berryhill, L.A.T.
• Bert E. Sharp, D.P.M., P.a.
• Bert E. Sharp, D.P.M., P.a.
• William Besong Besong, PHARMD
• Best Friends Adult Activity Center Inc (Best Friends Adult Activity Center)
• Best Friends Adult Activity Ctr, Inc. (The Spring House)
• Bethany HH of Longview (Bethany Home Health Services)
• Bethany Walker PLLC (Empowered Family Services)
• Beverly Advanced Practice Nursing, PLLC (The Beverly Clinic)

• Physical Therapist in Longview, TX
• Providers in Longview, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.