Serc Rehabilitation Partners LLC
Organization Active NPI Physical Therapist · Joplin, MO
NPI 1760746291 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1760746291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- SERC REHABILITATION PARTNERS LLC
- Practice address
- 1227 E 32ND St Ste 7
Joplin, MO 64804-2904 - Phone
- (417) 624-7400
- Fax
- (417) 624-7403
- NPI assigned
- Jun 29, 2012
- Organization subpart
- No
Authorized official
- Name
- Kevin Johanneson
- Title
- VP Revenue Cycle Operations
- Phone
- (423) 238-7217
Other NPIs on the same Medicare enrollment 18
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
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 This NPI is an additional NPI on the 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… |
National Provider Directory
- Tax ID family
- Serc Rebabilitation Partners LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
1227 E 32ND St Ste 7
Joplin, MO 64804-2904
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217
Other names
- SERC
- SERC - Joplin
Other providers in Joplin, MO
- Andi J Selby
- Donna Self
- Ashley Sellers
- Seniortrust of Joplin, LLC
- Jamie Sentlinger
- Jane Seto
- Brenon R Severe
- Kelsey Leigh Seward
- Judy Valeria Seymour
- Atman Shah
All providers in Joplin, 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 Jul 21, 2022. 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.