Homer Physical Therapy, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

1134 Issued in AK

Legal business name

HOMER PHYSICAL THERAPY, LLC

Practice address

4141 Pennock St
Homer, AK 99603-7223

Phone

(907) 235-3410

Fax

(907) 235-3417

NPI assigned

Aug 26, 2006

Last updated

Mar 22, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sallie W Rediske, MPTNPI 1336113943

Title

Owner

Phone

(907) 235-3410

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Sallie W Rediske, MPT

  • Physical Therapist
  • Homer, AK
  • NPI 1336113943
  Authorized official Same address or phone

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1750499224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 PENNOCK ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037223",
            "telephone_number": "907-235-3410",
            "fax_number": "907-235-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 PENNOCK ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037223",
            "telephone_number": "907-235-3410",
            "fax_number": "907-235-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-26",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "REDISKE",
        "authorized_official_first_name": "SALLIE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-235-3410",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AK",
            "license": "1134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homer Birth and Wellness Center
• Homer Dental Center Inc
• Homer Eyecare LLC
• Homer Massage Therapy
• Homer Medical Clinic, a Professional Corp
• Homer Psychological Services
• Homer Senior Citizens, Inc.
• Homer Senior Citizens, Inc.
• Homer Senior Citizens, Inc.
• Homer Senior Citizens, Inc.

• Orthopedic Physical Therapist in Homer, AK
• Providers in Homer, AK by specialty
• Orthopedic Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.