Ultimate Rehab, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ULTIMATE REHAB, PLLC

Practice address

1840 E State Highway 71
La Grange, TX 78945-4625

Phone

(979) 250-5135

Fax

(979) 250-5134

NPI assigned

Oct 17, 2022

Organization subpart

No

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

Authorized official

Name

Alaina Christen Petzold, PT, DPTNPI 1043970049

Title

Physical Therapist

Phone

(979) 250-5135

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alaina Christen Petzold, PT, DPT

  • Physical Therapist
  • La Grange, TX
  • NPI 1043970049
  Medicare reassignment Care Compare group NPD Authorized official
• Gilbert Henderson, L.P.T.

  • Physical Therapist
  • La Grange, TX
  • NPI 1174790265
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1689390239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 E STATE HIGHWAY 71",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789454625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 E STATE HIGHWAY 71",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789454625",
            "telephone_number": "979-250-5135",
            "fax_number": "979-250-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "PETZOLD",
        "authorized_official_first_name": "ALAINA",
        "authorized_official_middle_name": "CHRISTEN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "979-250-5135",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in La Grange, TX
• Providers in La Grange, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.