Serc Rehabilitation Partners LLC
Organization Active NPI Physical Therapy Clinic/Center · Rogers, AR
NPI 1689079899 · NPPES record last updated Oct 30, 2014
Key facts
- NPI
- 1689079899
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- SERC REHABILITATION PARTNERS LLC
- Practice address
- 2603 W Pleasant Grove Rd
Ste 104
Rogers, AR 72758-8514 - Phone
- (816) 226-4011
- Fax
- (816) 524-6115
- NPI assigned
- Oct 30, 2014
- Organization subpart
- No
Authorized official
- Name
- Kevin Johanneson
- Title
- VP Revenue Cycle Operations
- Phone
- (423) 238-7217
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150220000556 | AR | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9830344563 |
Receives reassigned benefits from 61 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tontitown, AR; Springdale, AR; Rogers, AR; Pea Ridge, AR; Maumelle, AR; Little Rock, AR; Hot Springs, AR; Fayetteville, AR… |
National Provider Directory
- Tax ID family
- Serc Rebabilitation Partners LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
2603 W Pleasant Grove Rd
Ste 104
Rogers, AR 72758-8514
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217
Other names
- SERC - Rogers
Other providers in Rogers, AR
- Brittany S Seifert
- Tucker Seifert
- Emily Seiler
- Jill Elizabeth Self-Pike
- Courtney Sellars
- Servant'S Heart Outreach
- Setrek Corporation
- Melita Setser
- Tyler James Severson
- Margaret Lynne Sexton
All providers in Rogers, AR · Physical Therapy Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.