NPIMap

Organization Active NPI

Central Physical Rehabilitation and Sports Medicine, LLC

  • Physical Therapy Clinic/Center
  • Warrensburg, MO
National Provider Identifier
1851425912
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CENTRAL PHYSICAL REHABILITATION AND SPORTS MEDICINE, LLC
Practice address
407 E Russell Ave BLDG a
Suite 6
Warrensburg, MO 64093-1242
Phone
(660) 429-4700
Fax
(660) 429-0500
NPI assigned
Mar 14, 2007
Last updated
Sep 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Shawn RoachNPI 1508802851
Title
Owner
Phone
(660) 429-4700

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 NU Primary

Addresses

Primary practice location

407 E Russell Ave BLDG a
Suite 6
Warrensburg, MO 64093-1242

Mailing address

407 E Russell Ave BLDG a
Suite 6
Warrensburg, MO 64093-1242
Phone (660) 429-4700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130729000144 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4486639093 Receives reassigned benefits from 7 practitioners
Practice locations: Warrensburg, MO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

407 E Russell Ave
#A6
Warrensburg, MO 64093
Phone (660) 429-4700

407 E Russell Ave
Ste 6
Warrensburg, MO 64093
Phone (660) 429-4700

Practitioners & affiliated clinicians

Practitioners 10

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1851425912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E RUSSELL AVE BLDG A",
            "address_2": "SUITE 6",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931242",
            "telephone_number": "660-429-4700",
            "fax_number": "660-429-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E RUSSELL AVE BLDG A",
            "address_2": "SUITE 6",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640931242",
            "telephone_number": "660-429-4700",
            "fax_number": "660-429-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PHYSICAL REHABILITATION AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-429-4700"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.