Progressive Rehabilitation Group, Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

PT00008835 Issued in WA

Legal business name

PROGRESSIVE REHABILITATION GROUP, INC.

Doing business as

New Paradigm Physical Therapy

Practice address

1 Coulee Blvd West
Electric City, WA 99123

Phone

(509) 429-3355

NPI assigned

Oct 4, 2011

Last updated

Oct 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Schober, MPTNPI 1063678472

Title

President

Phone

(509) 429-3355

Specialties & licenses 1

Addresses

Other names 1

• New Paradigm Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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.

• Justin Schober, MPT

  • Physical Therapist
  • Electric City, WA
  • NPI 1063678472
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1821372293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E ANSEL AVE",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988129609",
            "telephone_number": "509-429-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COULEE BLVD WEST",
            "city": "ELECTRIC CITY",
            "state": "WA",
            "postal_code": "99123",
            "telephone_number": "509-429-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE REHABILITATION GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHOBER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-429-3355",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "PT00008835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Paradigm Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Esther Walberg Derusha, LMP
• Justin Schober, MPT

• Preferred Provider Organization in Electric City, WA
• Providers in Electric City, WA by specialty
• Preferred Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.