Lauren Prescott
Individual provider Active NPI Physical Therapist · Goshen, IN
NPI 1740975465 · NPPES record last updated Apr 7, 2023
Key facts
- NPI
- 1740975465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 1775 E Kercher Rd
Goshen, IN 46526-6308 - Phone
- (574) 533-0300
- NPI assigned
- Apr 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Innovative Physical Therapy LLC
Practice addresses (Care Compare)
502 E 1100
Innovative Physical Therapy
Chesterton, IN 46304-9697
Phone 21992658501
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240405000636 | IN | Practitioner - Physical Therapist in Private Practice | 7618315904 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Health, LLC | Physical Therapist | Current |
Accepting new patients |
| Innovative Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Beacon Health, LLC | Past | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
502 E 1100 N
Chesterton, IN 46304
Phone (219) 926-5850
3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129
3221 Beacon Pkwy
Ste 100
Granger, IN 46530
Phone (574) 647-2930
1815 E Ireland Rd
#100
South Bend, IN 46614
Phone (574) 647-5790
265 Morthland Dr
Ste A
Valparaiso, IN 46383
Phone 2199265850 ext. 2
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
1775 E Kercher Rd
Goshen, IN 46526-6308
Mailing address
1775 E Kercher Rd
Goshen, IN 46526-6308
Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2023. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.