Legacy Physical Therapy
Organization Active NPI Physical Therapy Clinic/Center · Hardinsburg, KY
NPI 1740810936 · NPPES record last updated Jun 30, 2021
Key facts
- NPI
- 1740810936
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- LEGACY PHYSICAL THERAPY
- Practice address
- 237 E Highway 60
Hardinsburg, KY 40143-4892 - Phone
- (859) 229-2203
- NPI assigned
- Jan 16, 2020
- Organization subpart
- No
Authorized official
- Name
- Matthew Mattingly, MPT
- Title
- Owner
- Phone
- (859) 229-2203
Practitioners 6
-
James Patrick Couch, MSPT
-
Sarah P Mattingly, MSPT
-
Thomas Matthew Mattingly, MSPT
-
Ana Reed, DPT
-
Casey S Roach, PHYSICAL THERAPIST
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200501001192 | KY | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2961832159 |
Receives reassigned benefits from 6 practitioners Practice locations: Hardinsburg, KY; Winchester, KY |
National Provider Directory
Locations
237 E Highway 60
Hardinsburg, KY 40143
Phone (270) 580-4444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
237 E Highway 60
Hardinsburg, KY 40143-4892
Mailing address
237 E Highway 60
Hardinsburg, KY 40143-4892
Other practice location 1
170 Pedro Way
Winchester, KY 40391-8354
Phone (859) 385-5031
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639165210 | Medicaid | KY | |
| 1639165210 | Other | KY | BCBS |
Other providers in Hardinsburg, KY
- Erica Renee Johnston
- Kent'S Chiropratic PSC
- Victoria Michelle Kerr
- Claire Elizabeth Knott
- Halie N Koch
- Catherine M Lewis
- Tiffany Lucas
- Ruth A Martin
- Kimberly Ann Matthews
- Sarah P Mattingly
All providers in Hardinsburg, KY · Physical Therapy Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2021. 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.