Russellville Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RUSSELLVILLE PHYSICAL THERAPY, INC

Practice address

1703 West Main Street
Suite a
Russellville, AR 72801

Phone

(479) 970-2008

NPI assigned

Aug 19, 2022

Organization subpart

No

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

Authorized official

Name

Laken Baldwin, DPTNPI 1083133532

Title

Co-Owner

Phone

(479) 970-2008

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laken Nicolle Baldwin, DPT

  • Physical Therapist
  • Russellville, AR
  • NPI 1083133532
  Medicare reassignment Care Compare group NPD Authorized official
• Wesley Hoover

  • Physical Therapist
  • Russellville, AR
  • NPI 1841060423
  Medicare reassignment Care Compare group NPD
• Rebecca Mize, PT, DPT

  • Physical Therapist
  • Russellville, AR
  • NPI 1518731074
  Medicare reassignment Care Compare group NPD
• Haley Mourot

  • Orthopedic Physical Therapist
  • Morrilton, AR
  • NPI 1275933772
  Medicare reassignment NPD
• Sadra Siebenmorgen, PT, DPT

  • Physical Therapist
  • Topeka, KS
  • NPI 1447809702

  AR

  Medicare reassignment NPD

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1831817378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728110671",
            "telephone_number": "479-970-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 WEST MAIN STREET",
            "address_2": "SUITE A",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-970-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-10-28",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "LAKEN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "479-970-2008",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@russellvillept.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1703 West Main Street",
            "address_2": "Suite A",
            "city": "Russellville",
            "state": "AR",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Russellville Holdings LLC
• Russellville Holdings LLC
• Russellville Holdings LLC
• Russellville Holdings LLC
• Russellville Pediatric & Adolescent Clinic, PA
• Russellville Primary Care Clinic, Inc.
• Russellville School District
• Russellville Women'S Clinic
• Kelly Marie Ruther
• Amanda Caitlyn Ryan

• Physical Therapy Clinic/Center in Russellville, AR
• Providers in Russellville, AR by specialty
• Physical Therapy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.