NPIMap

Organization Active NPI

Dora Roberts Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Big Spring, TX
National Provider Identifier
1760486708
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
DORA ROBERTS REHABILITATION CENTER
Practice address
306 W 3Rd St
Big Spring, TX 79720-2429
Phone
(432) 267-3806
Fax
(432) 267-3809
NPI assigned
Jun 8, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Penny Phillips
Title
Executive Director
Phone
(432) 267-3806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X TX Primary

Addresses

Primary practice location

306 W 3Rd St
Big Spring, TX 79720-2429

Mailing address

306 W 3Rd St
Big Spring, TX 79720-2429
Phone (432) 267-3806

Other identifiers 1

IdentifierTypeStateIssuer
00L09GOtherTXMEDICARE B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040621000429 TX Part B Supplier - Clinic/Group Practice 0941285498 Receives reassigned benefits from 1 practitioner
Practice locations: Big Spring, TX
O20120110000464 TX Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0941285498 Practice locations: Big Spring, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760486708. Details of each certification follow.

  • CCN 456536 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 456536

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DORA ROBERTS REHABILITATION CE
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
May 15, 1979
Last certification
Apr 19, 2016
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
306 West 3Rd Street
Big Spring, TX 79720

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 116

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.

View all 116

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760486708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W 3RD ST",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797202429",
            "telephone_number": "432-267-3806",
            "fax_number": "432-267-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W 3RD ST",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797202429",
            "telephone_number": "432-267-3806",
            "fax_number": "432-267-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORA ROBERTS REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "432-267-3806"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "00L09G",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Spring, TX

Sources for this page

Verify at the official NPI Registry.