Providence Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

11-03608 Issued in KS

Legal business name

PROVIDENCE PHYSICAL THERAPY

Practice address

3737 W Central Ave
Wichita, KS 67203-4925

Phone

(316) 445-0553

Fax

(316) 221-2528

NPI assigned

Feb 16, 2016

Organization subpart

No

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

Authorized official

Name

Howard Christopher Deck, PT

Title

Owner

Phone

(316) 833-6675

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Allysa Lynn Hupko, LMSW

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1356899504
  NPD (past)

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1851750145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10014 W HASKELL CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672093006",
            "telephone_number": "316-448-0553",
            "fax_number": "316-221-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034925",
            "telephone_number": "316-445-0553",
            "fax_number": "316-221-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "DECK",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-833-6675",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "KS",
            "license": "11-03608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pronab K Sensarma MD PA
• Frank Provenzano, MD
• John R Provenzano, DDS
• Providence Home Health & Hospice LLC
• Providence Home Health & Hospice LLC.
• Jessica Lynn Provines, TLMLP
• Macey Pruett, OD
• Micaela Elizabeth Pruiett, LPC
• Mary Molly Loren Pruit
• Lou Ann Prusa, LCMFT

• Physical Therapy Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Physical Therapy Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.