Active NPI
Advanced Physical Therapy Services LTD
- Physical Therapist
- Bloomington, IL
National Provider Identifier
1760640262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- ADVANCED PHYSICAL THERAPY SERVICES LTD
- Practice address
- 135 N Williamsburg Dr
Bloomington, IL 61704-3528 - Phone
- (309) 661-8823
- Fax
- (309) 661-8801
- NPI assigned
- May 30, 2008
- Organization subpart
- Yes
- Parent organization
- ADVANCED PHYSICAL THERAPY SERVICES LTD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael R Salaway
- Title
- President of Operations
- Phone
- (309) 661-8823
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
135 N Williamsburg Dr
Bloomington, IL 61704-3528
Mailing address
PO Box 47
Bloomington, IL 61702-0047
Phone (309) 661-8823
Other names 1
- Advanced Rehab and Sports Medicine
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041207000017 | IL | Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 9133101462 |
1 other NPI on this enrollment Practice locations: Bloomington, IL |
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Physical Therapist
- Bloomington, IL
- NPI 1437141504
9133101462
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Physical Therapist
- Bloomington, IL
- NPI 1437141504
O20041207000017
National Provider Directory
National Provider Directory- Tax ID family
- Advanced Rehab Sports Medicine
- Part of
- Advanced Rehab Sports Medicine
Other organizations with this tax ID 9
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapy Clinic/Center
- Monmouth, IL
- NPI 1295472017
-
- Physical Therapist
- Galesburg, IL
- NPI 1669119582
-
- Physical Therapy Clinic/Center
- Aledo, IL
- NPI 1770843443
-
- Physical Therapist
- Kewanee, IL
- NPI 1184882961
-
- Physical Therapist
- Macomb, IL
- NPI 1336307115
-
- Physical Therapist
- Toulon, IL
- NPI 1528219607
-
- Physical Therapist
- Canton, IL
- NPI 1932367810
-
- Physical Therapist
- Monmouth, IL
- NPI 1235121393
-
- Physical Therapist
- West Burlington, IA
- NPI 1508017682
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652918400000",
"number": "1760640262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 47",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617020047",
"telephone_number": "309-661-8823",
"fax_number": "309-661-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 N WILLIAMSBURG DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043528",
"telephone_number": "309-661-8823",
"fax_number": "309-661-8801"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED PHYSICAL THERAPY SERVICES LTD",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADVANCED PHYSICAL THERAPY SERVICES LTD",
"enumeration_date": "2008-05-30",
"last_updated": "2022-05-19",
"certification_date": "2022-05-19",
"status": "A",
"authorized_official_last_name": "SALAWAY",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRESIDENT OF OPERATIONS",
"authorized_official_telephone_number": "309-661-8823",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Advanced Rehab and Sports Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Advanced Rehab and Sports Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.