Serc Rehabilitation Partners, LLC
Organization Active NPI Physical Therapist · Belton, MO
NPI 1760745244 · NPPES record last updated Dec 9, 2014
Key facts
- NPI
- 1760745244
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- SERC REHABILITATION PARTNERS, LLC
- Practice address
- 17134 Bel Ray PL
Belton, MO 64012-5331 - Phone
- (816) 226-4011
- Fax
- (816) 524-6115
- NPI assigned
- Jun 20, 2012
- Organization subpart
- No
Authorized official
- Name
- Kevin Johanneson
- Title
- Manager
- Phone
- (423) 238-8923
Other NPIs on the same Medicare enrollment 19
Other NPIs with the same Medicare PAC ID 1
Practitioners 339
-
Kelsey Nicole Anderson, PT, DPT
-
Madison Suzanne Anderson, OT, MOT
-
Kathleen A Atchison, OTR/L, CHT
-
Riley Tegan Atwell, PT, DPT
-
Tiffany Nicole Ayasse, PT, DPT
-
Lindsey Marie Bales, PT, DPT
-
Alyssa Bayard, DPT
-
Samuel J Boone, OTR
-
Sydney Erin-Anderson Carter, OT, MOT
-
Jeremy Carver, PT
-
Sang Yong Chung, PT, DPT
-
Janie Miranda Coffey, PT, MPT
-
Andrew Michael Cook, PT, DPT
-
Eric Davis, PT, DPT
-
Darshan A Deole, DPT
-
Emily Anne Fasbender, PT, DPT
-
Megan Rose Flanagin, PT, DPT
-
Brooklyn Ruth Fulk, DPT
-
Adam Cole Gerke, PT, DPT
-
Emily Rene Gourley, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MO, KS, AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130304000500 | MO | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9830344563 |
Receives reassigned benefits from 207 practitioners 18 other NPIs on this enrollment Practice locations: Lake Ozark, MO; Lees Summit, MO; Mount Vernon, MO; Kansas City, MO; Oak Grove, MO; Odessa, MO; Platte City, MO; Pleasant Hill, MO… |
| O20130517000516 | KS | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9830344563 |
Receives reassigned benefits from 107 practitioners Practice locations: Atchison, KS; Wichita, KS; Topeka, KS; Spring Hill, KS; Shawnee, KS; Overland Park, KS; Ottawa, KS; Eudora, KS… |
| O20150220000556 | AR | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9830344563 |
Receives reassigned benefits from 61 practitioners 1 other NPI on this enrollment Practice locations: Tontitown, AR; Springdale, AR; Rogers, AR; Pea Ridge, AR; Maumelle, AR; Little Rock, AR; Hot Springs, AR; Fayetteville, AR… |
National Provider Directory
Locations (25 of 33)
20320 I 30
Ste 190
Benton, AR 72019
Phone (501) 500-8188
1000 SE Walton Blvd
Ste 18
Bentonville, AR 72712
Phone (479) 480-5008
1240 E Centerton Blvd
Centerton, AR 72719
Phone (479) 795-0173
605 Salem Rd
Ste A5
Conway, AR 72034
Phone (501) 441-4862
1261 N Steamboat Dr
Ste 2
Fayetteville, AR 72704
Phone (479) 313-6591
222 Wellington Hills Rd
#100
Little Rock, AR 72211
Phone (501) 604-8088
222 Wellington Hills Rd
Little Rock, AR 72211
Phone (501) 604-8088
1328 Slack St
Pea Ridge, AR 72751
1331 E Henri de Tonti Blvd
Tontitown, AR 72762
650 Congressional Dr
Ste D
Lawrence, KS 66049
Phone (785) 588-4170
5799 Broadmoor St
Ste 300
Mission, KS 66202
Phone (913) 384-5600
1410 S Main St
Ottawa, KS 66067
Phone (785) 242-2110
11120 Antioch Rd
Ste 17
Overland Park, KS 66210
Phone (913) 451-7372
13847 W 63rd St
#2
Shawnee, KS 66216
Phone (913) 962-7774
13847 W 63rd St
Ste 2
Shawnee, KS 66216
Phone (913) 962-7770
21161 W 223rd St
Spring Hill, KS 66083
Phone (913) 686-3333
6749 SW 29th St
Ste B1
Topeka, KS 66614
3405 NW Hunters Ridge Ter
#30
Topeka, KS 66618
1707 SE 29th St
Ste 300
Topeka, KS 66605
Phone (785) 266-4600
1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051
11902 Blue Ridge Ext
#11906B
Grandview, MO 64030
11902 Blue Ridge Ext
Ste B
Grandview, MO 64030
815 Westchester Ave
Harrisonville, MO 64701
Phone (816) 331-9111
678 S Commercial St
Harrisonville, MO 64701
Phone (816) 380-3325
180 Mall Rd
Ste K
Hollister, MO 65672
Phone (417) 263-3045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Ergonomics Occupational Therapist |
225XE1200X | |||
| Hand Occupational Therapist |
225XH1200X |
Addresses
Primary practice location
17134 Bel Ray PL
Belton, MO 64012-5331
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KA2868 | Other | KS | MEDICARE PTAN |
| MA4370 | Other | MO | MEDICARE PTAN |
Other names
- SERC
Other providers in Belton, MO
- Miriam Scott
- Katherine M Scranton
- Serc Hand of Cass County L.L.C.
- Serc Hand of Cass County LLC
- Serc Rehabilitation Partners LLC
- Serc Rehabilitation Partners, LLC
- Sydney Shatzer
- Sophia Sheikh
- Karen Elizabeth Shriner
- Austin M Shrout
All providers in Belton, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2014. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.