NPIMap

Organization Active NPI

Orthopaedic Motion & Sport Physical

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1881786705
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004050 Issued in KY
Legal business name
ORTHOPAEDIC MOTION & SPORT PHYSICAL
Practice address
6008 Brownsboro Park Blvd
Suite C
Louisville, KY 40207-1295
Phone
(502) 899-4760
Fax
(502) 899-4719
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
Ms. Bridgid M Mahan, DPT, OCS, SCS
Title
Owner
Phone
(502) 899-4760

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 004050 KY Primary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X 004050 KY
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X 004050 KY

Addresses

Primary practice location

6008 Brownsboro Park Blvd
Suite C
Louisville, KY 40207-1295

Mailing address

6008 Brownsboro Park Blvd
Suite C
Louisville, KY 40207-1295
Phone (502) 899-4760

Other identifiers 1

IdentifierTypeStateIssuer
000000505120OtherKYANTHEM

National Provider Directory

National Provider Directory

Locations

6008 Brownsboro Park Blvd
Ste C
Louisville, KY 40207
Phone (502) 899-4760

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1881786705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6008 BROWNSBORO PARK BLVD",
            "address_2": "SUITE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402071295",
            "telephone_number": "502-899-4760",
            "fax_number": "502-899-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6008 BROWNSBORO PARK BLVD",
            "address_2": "SUITE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402071295",
            "telephone_number": "502-899-4760",
            "fax_number": "502-899-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC MOTION & SPORT PHYSICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "BRIDGID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-899-4760",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DPT, OCS, SCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004050",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "KY",
            "license": "004050",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KY",
            "license": "004050",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000505120",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.