Active NPI
Advanced Physical Therapy, LLC
- Durable Medical Equipment & Medical Supplies
- South Bend, IN
National Provider Identifier
1710618673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- ADVANCED PHYSICAL THERAPY, LLC
- Practice address
- 3510 Portage Rd
South Bend, IN 46628-6091 - Phone
- (574) 203-9527
- NPI assigned
- Jun 22, 2022
- Last updated
- Apr 30, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wade A Meyer
- Title
- VP Chief Compliance Officer
- Phone
- (630) 296-2222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
3510 Portage Rd
South Bend, IN 46628-6091
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
National Provider Directory
National Provider Directory- Tax ID family
- Advanced Physical Therapy LLC
Other organizations with this tax ID 14
Organizations that report the same tax identification number in the National Provider Directory.
-
dba ATI Physical Therapy of Indiana
- Occupational Therapist
- Indianapolis, IN
- NPI 1063798981
-
dba ATI Physical Therapy of Indiana
- Durable Medical Equipment & Medical Supplies
- Indianapolis, IN
- NPI 1508142746
-
dba ATI Physical Therapy of Indiana
- Durable Medical Equipment & Medical Supplies
- Indianapolis, IN
- NPI 1699051839
-
- Durable Medical Equipment & Medical Supplies
- Fishers, IN
- NPI 1023621893
-
- Durable Medical Equipment & Medical Supplies
- Granger, IN
- NPI 1316649213
-
dba ATI Physical Therapy
- Physical Therapist
- Indianapolis, IN
- NPI 1316940505
-
- Durable Medical Equipment & Medical Supplies
- Mishawaka, IN
- NPI 1558986828
-
- Durable Medical Equipment & Medical Supplies
- Valparaiso, IN
- NPI 1629709589
-
- Durable Medical Equipment & Medical Supplies
- Indianapolis, IN
- NPI 1700595089
-
- Durable Medical Equipment & Medical Supplies
- Lafayette, IN
- NPI 1760135305
-
- Durable Medical Equipment & Medical Supplies
- Muncie, IN
- NPI 1851059463
-
- Physical Therapist
- Indianapolis, IN
- NPI 1891865648
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba ATI Physical Therapy
- Durable Medical Equipment & Medical Supplies
- Forest Hill, MD
- NPI 1013109099
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714435200000",
"number": "1710618673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3510 PORTAGE RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466286091",
"telephone_number": "574-203-9527"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED PHYSICAL THERAPY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-22",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A",
"authorized_official_last_name": "MEYER",
"authorized_official_first_name": "WADE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "VP CHIEF COMPLIANCE OFFICER",
"authorized_official_telephone_number": "630-296-2222"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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- Advanced Rehabilitation Center
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- Yamna Matin Afridi
- Alice Nshamamba Aganze
- Mabel R Aghimien, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.