NPIMap

Organization Active NPI

Community Rehab, Inc

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1720197569
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
N/A Issued in NE
Legal business name
COMMUNITY REHAB, INC
Practice address
2027 Dodge St
The Scoular Building
Omaha, NE 68102-1240
Phone
(402) 884-8775
Fax
(402) 884-8632
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Mary J Theiler, MPT
Title
Owner/Physical Therapist
Phone
(402) 721-3908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X N/A NE Primary

Addresses

Primary practice location

2027 Dodge St
The Scoular Building
Omaha, NE 68102-1240

Mailing address

2027 Dodge St
Omaha, NE 68102-1240
Phone (402) 884-8775

Other identifiers 6

IdentifierTypeStateIssuer
640579MedicaidNE
S561OtherNEMIDLANDS CHOICE
10025293800MedicaidNE
01805OtherNEBLUE CROSS BLUE SHIELD
0586339MedicaidIA
83270OtherNECOVENTRY

Other names 1

  • Community Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000486 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173428562 Receives reassigned benefits from 29 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, NE; South Sioux City, NE; Plattsmouth, NE; Omaha, NE; La Vista, NE

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2027 Dodge St
Omaha, NE 68102
Phone (402) 884-8775

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1720197569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681021240",
            "telephone_number": "402-884-8775",
            "fax_number": "402-884-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2027 DODGE ST",
            "address_2": "THE SCOULAR BUILDING",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681021240",
            "telephone_number": "402-884-8775",
            "fax_number": "402-884-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "THEILER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "402-721-3908",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640579",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "S561",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025293800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01805",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0586339",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "83270",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.