NPIMap

Organization Active NPI

Premier Physical Therapy & Rehab, LLC.

  • Physical Therapist
  • Cape Girardeau, MO
National Provider Identifier
1689605867
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
117769 Issued in MO
Legal business name
PREMIER PHYSICAL THERAPY & REHAB, LLC.
Practice address
1405 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171
Phone
(573) 335-7868
NPI assigned
Jul 5, 2006
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dennis Riney, PTNPI 1245276237
Title
Owner
Phone
(573) 335-7868

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 117769 MO Primary
Occupational Therapist 225X00000X 000355 MO

Addresses

Primary practice location

1405 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171

Mailing address

1405 N Mount Auburn Rd Ste 400
Cape Girardeau, MO 63701-2171
Phone (573) 335-7868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060911000338 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254335060 Receives reassigned benefits from 7 practitioners
Practice locations: Advance, MO; Cape Girardeau, MO; Jackson, MO
O20110210000988 MO DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 1254335060 Practice locations: Cape Girardeau, MO

National Provider Directory

National Provider Directory

Locations

33501 State Highway 25
Advance, MO 63730
Phone (573) 722-9999

1405 N Mount Auburn Rd
Ste 400
Cape Girardeau, MO 63701

1405 N Mount Auburn Rd
Cpe Girardeau, MO 63701
Phone (573) 335-7868

2917 Independence St
Ste 400
Cpe Girardeau, MO 63703
Phone (573) 335-7868

2480 E Main St
Ste B
Jackson, MO 63755
Phone (573) 204-7868

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1689605867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 N MOUNT AUBURN RD STE 400",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-335-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-335-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL THERAPY & REHAB, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "RINEY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-335-7868",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "117769",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "000355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.