Christopher Stan Rafacz, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14096 Issued in TN

Practice address

1700 W Market St Ste F&G
Bolivar, TN 38008-1653

Phone

(731) 658-2206

Fax

(731) 659-2061

NPI assigned

Aug 19, 2020

Last updated

Mar 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, AZ, OR, WA4 enrollments

Enrollment records 4

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kitsap Physical Therapy and Sports Clinic PS IncGroup PAC ID 6507762333, 142 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.09 of 100Reported as group

Quality

89.13

Improvement activities

40

Cost

73.57

Merit-based Incentive Payment System (MIPS)

Final score

96.6 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Physical Therapist
  • Silverdale, WA
  • NPI 1912902347
  Medicare reassignment Care Compare group NPD
• Athletic and Therapeutic Institute of Naperville LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Aurora, IL
  • NPI 1023129681
  Medicare reassignment NPD
• Ati Holdings of Arizona, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1871570309
  Medicare reassignment NPD
• New Proactive LLC

  dba ProActive Physical Therapy

  • Physical Therapy Clinic/Center
  • Oregon City, OR
  • NPI 1396273199

  Physical Therapist

  Medicare reassignment NPD
• Athletic and Therapeutic Institute of Naperville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hazel Crest, IL
  • NPI 1043952641
  NPD
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Durable Medical Equipment & Medical Supplies
  • Kingston, WA
  • NPI 1700466083

  Physical Therapist

  NPD
• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)
• Omnis Omnia Inc.

  dba Peak Performance Physical Therapy

  • Orthopedic Physical Therapist
  • Redmond, OR
  • NPI 1013949239
  NPD (past)
• Star Physical Therapy LP

  • Physical Therapist
  • Caruthersville, MO
  • NPI 1073375861
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1902418197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W MARKET ST STE F&G",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081653",
            "telephone_number": "731-658-2206",
            "fax_number": "731-659-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFACZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "STAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-19",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013856A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029723",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Quality Transport LLC
• Harlis Reese, MA
• Susanna Reid
• Meryl Rice, LCSW
• David R Richie, PH,D
• Jeffrey M Robbins, M.D.

• Physical Therapist in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.