Individual provider Active NPI

Ross Patrick Fenimore

  • Physical Therapist
  • Franklin, IN
National Provider Identifier
1891341772
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013494A Issued in IN
Practice address
1057 W Jefferson St
Franklin, IN 46131-2177
Phone
(317) 668-0526
Fax
(317) 315-8755
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05013494A IN Primary

Addresses

Primary practice location

1057 W Jefferson St
Franklin, IN 46131-2177

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826003316 IN Practitioner - Physical Therapist in Private Practice 9032447214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1057 W Jefferson St
Franklin, IN 46131-2177
Phone (317) 668-0526

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05013494AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2019 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

1057 W Jefferson St
Franklin, IN 46131
Phone (317) 668-0526

2421 N Morton St
Franklin, IN 46131
Phone (317) 738-4401

3229 Broadway
Gary, IN 46409
Phone (219) 326-2324

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1891341772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 W JEFFERSON ST",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461312177",
            "telephone_number": "317-668-0526",
            "fax_number": "317-315-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENIMORE",
        "first_name": "ROSS",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013494A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.