NPIMap

Organization Active NPI

Lincoln Physical Therapy and Sports Rehab LLC

  • Physical Therapist
  • Georgetown, TX
National Provider Identifier
1881347623
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LINCOLN PHYSICAL THERAPY AND SPORTS REHAB LLC
Practice address
4879 Williams Dr Ste 103
Georgetown, TX 78633-2311
Phone
(512) 843-0118
NPI assigned
Feb 1, 2022
Last updated
Jan 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Authorized official

Name
Deb Ann Weber
Title
Credentialing
Phone
(402) 802-9157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

4879 Williams Dr Ste 103
Georgetown, TX 78633-2311

Mailing address

6940 Van Dorn St Ste 103
Lincoln, NE 68506-2858
Phone (402) 802-9157

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dweber@lincolnpt.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220330002302 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9133438641 Receives reassigned benefits from 9 practitioners
Practice locations: Georgetown, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lincoln Physical Therapy and Sports Rehab LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4451 N 26th St
Ste 1000
Lincoln, NE 68521
Phone (402) 476-2600

6940 Van Dorn St
Ste 103
Lincoln, NE 68506
Phone (402) 483-4709

4881 Williams Dr
Ste 103
Georgetown, TX 78633
Phone (402) 802-9157

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1881347623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6940 VAN DORN ST STE 103",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062858",
            "telephone_number": "402-802-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4879 WILLIAMS DR STE 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332311",
            "telephone_number": "512-843-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PHYSICAL THERAPY AND SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "DEB",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "402-802-9157"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dweber@lincolnpt.com",
            "affiliation": "N",
            "address_1": "4879 Williams Dr Ste 103",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786332311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.