NPIMap

Organization Active NPI

Advanced Physical Therapy Services LTD

Doing business as Advanced Rehab and Sports Medicine

  • Physical Therapist
  • Bloomington, IL
National Provider Identifier
1760640262
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ADVANCED PHYSICAL THERAPY SERVICES LTD
Doing business as
Advanced Rehab and Sports Medicine
Practice address
135 N Williamsburg Dr
Bloomington, IL 61704-3528
Phone
(309) 661-8823
Fax
(309) 661-8801
NPI assigned
May 30, 2008
Last updated
May 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED PHYSICAL THERAPY SERVICES LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Authorized official

Name
Mr. Michael R SalawayNPI 1467450627
Title
President of Operations
Phone
(309) 661-8823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Advanced Physical Therapy10 organizations share this tax ID, including this one
Part of
Advanced Physical Therapy

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

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.

Verify at the official NPI Registry.