Prorehab, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

101106 Issued in KY

Legal business name

PROREHAB, INC

Doing business as

Kentucky Physical Therapy Specialists

Practice address

1075 N Main St
Madisonville, KY 42431-1288

Phone

(270) 643-5787

Fax

(270) 643-0364

NPI assigned

Sep 3, 2010

Last updated

Jan 18, 2023By 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

Andrea L. Baumann

Title

Coo

Phone

(812) 759-7473

Specialties & licenses 2

Addresses

Other names 1

• Kentucky Physical Therapy Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Prorehab Inc

  dba ProRehab of Bowling Green

  • Physical Therapy Clinic/Center
  • Bowling Green, KY
  • NPI 1760976146

  O20180712001913

  Same enrollment
• Prorehab Inc

  • Physical Therapy Clinic/Center
  • Bowling Green, KY
  • NPI 1962052043

  O20180712001913

  Same enrollment
• Prorehab, Inc

  • Physical Therapist
  • Owensboro, KY
  • NPI 1801480223

  O20180712001913

  Same enrollment
• Prorehab, Inc

  • Physical Therapy Clinic/Center
  • Henderson, KY
  • NPI 1972765386

  O20180712001913

  Same enrollment
• Prorehab Inc

  • Physical Therapist
  • Evansville, IN
  • NPI 1770565509

  O20180712001913

  Same enrollment

Locations

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.

• Robert Tank, PT, ATC, MA

  • Physical Therapist
  • Evansville, IN
  • NPI 1124002795
  NPD (past)

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1831406354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "812-401-3258",
            "fax_number": "812-401-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N MAIN ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311288",
            "telephone_number": "270-643-5787",
            "fax_number": "270-643-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-03",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "BAUMANN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "812-759-7473"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "KY",
            "license": "101106",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky Physical Therapy Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Dawn Powers, APRN
• Practitioner Touch LLC (Practitioner Touch)
• Stephanie Danielle Pride, COTA
• Katlin Pritchett, PHARMD
• Prorehab of Kentucky, LLC (Kentucky Physical Therapy Specialists)
• Josh Pruitt, PHARMD, BCIDP
• Debra Lynn Pugh
• Paul Putarek Jr., RPH
• Rennan M Quijano, M.D.
• Michael Wayne Rager, PRESIDENT & CEO

• Physical Therapy Clinic/Center in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Physical Therapy Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.