NPIMap

Organization Active NPI

Advanced Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Lincoln, NE
National Provider Identifier
1811448640
Registry record updated Jan 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ADVANCED PHYSICAL THERAPY LLC
Practice address
5640 S 84TH St
100
Lincoln, NE 68516-4471
Phone
(402) 486-0602
Fax
(402) 486-0604
NPI assigned
Oct 17, 2016
Last updated
Jan 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2017

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

Authorized official

Name
Ethan Evert, P.T.NPI 1578019063
Title
Owner
Phone
(402) 486-0602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5640 S 84TH St
100
Lincoln, NE 68516-4471

Mailing address

5640 S 84TH St
100
Lincoln, NE 68516-4471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170207002318 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406139997 Receives reassigned benefits from 7 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

5640 S 84th St
Ste 100
Lincoln, NE 68516
Phone (402) 486-0602

Practitioners & affiliated clinicians

Practitioners 9

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": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483315200000",
    "number": "1811448640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 S 84TH ST",
            "address_2": "100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 S 84TH ST",
            "address_2": "100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164471",
            "telephone_number": "402-486-0602",
            "fax_number": "402-486-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2017-01-02",
        "status": "A",
        "authorized_official_last_name": "EVERT",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-486-0602",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; 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.