NPIMap

Organization Active NPI

Pain Managment Joint Venture LLP

  • Physical Therapist
  • Longview, TX
National Provider Identifier
1871540971
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5500600000 Issued in TX
Legal business name
PAIN MANAGMENT JOINT VENTURE LLP
Practice address
3202 N 4TH St
Suite 101
Longview, TX 75605-5143
Phone
(903) 753-6635
Fax
(903) 236-3185
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Mr. Thomas A Lorren, PTNPI 1154383628
Title
Managing Partner
Phone
(903) 753-6635

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 650460000 TX
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 5500600000 TX Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X 5500600000 TX

Addresses

Primary practice location

3202 N 4TH St
Suite 101
Longview, TX 75605-5143

Mailing address

3202 N 4TH St
Suite 101
Longview, TX 75605-5143
Phone (903) 753-6635

Other identifiers 2

IdentifierTypeStateIssuer
0071BTOtherTXBLUE CROSS
021731701MedicaidTX

Other names 1

  • Centre Of Rehabilitation Excellence Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 456819

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CENTRE OF REHABILITATION EXCELLENCE
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Dec 13, 1997
Last certification
Oct 13, 2015
Ownership / control type
Proprietary
Facility address
3202 N Fourth St Ste 101
Longview, TX 75605

National Provider Directory

National Provider Directory

Locations

123 US Hwy 259 S
Daingerfield, TX 75638
Phone (903) 656-2419

3202 4th St
Ste 101
Longview, TX 75605

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1871540971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 N 4TH ST",
            "address_2": "SUITE 101",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055143",
            "telephone_number": "903-753-6635",
            "fax_number": "903-236-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 N 4TH ST",
            "address_2": "SUITE 101",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055143",
            "telephone_number": "903-753-6635",
            "fax_number": "903-236-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGMENT JOINT VENTURE LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "LORREN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "903-753-6635",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "650460000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "5500600000",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "5500600000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0071BT",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021731701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centre Of Rehabilitation Excellence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.