NPIMap

Organization Active NPI

Physical Therapy Associates Inc

  • Physical Therapist
  • Mt Washington, KY
National Provider Identifier
1902770530
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY ASSOCIATES INC
Practice address
141 Eastbrooke Pointe Dr E
Mt Washington, KY 40047-7383
Phone
(502) 251-5145
Fax
(502) 251-5130
NPI assigned
Oct 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Guy Robert WallaceNPI 1477605772
Title
Owner
Phone
(270) 234-1569

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

141 Eastbrooke Pointe Dr E
Mt Washington, KY 40047-7383

Mailing address

614 Westport Rd Ste a
Elizabethtown, KY 42701-3832
Phone (270) 234-1569

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000469 KY Part B Supplier - Clinic/Group Practice 4880591270 Receives reassigned benefits from 18 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elizabethtown, KY; Radcliff, KY; Mt Washington, KY; Hodgenville, KY; Brandenburg, KY; Bardstown, KY

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physical Therapy Associates Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

914 N Dixie Ave
Ste 205
Elizabethtown, KY 42701
Phone (270) 735-1433

1321 Ring Rd
Ste 103
Elizabethtown, KY 42701
Phone (270) 982-1800

632 S Lincoln Blvd
Hodgenville, KY 42748
Phone (270) 358-9765

104 E Main St
Ste 104
Hodgenville, KY 42748
Phone (270) 358-9765

390 W 17th St
Hopkinsville, KY 42240
Phone (270) 881-9016

4438 Dixie Hwy
Louisville, KY 40216
Phone (502) 447-4388

4331 Churchman Ave
Louisville, KY 40215
Phone (502) 366-1773

1929 Blankenbaker Pkwy
Louisville, KY 40299
Phone (502) 240-0149

800 W Lincoln Trail Blvd
Radcliff, KY 40160
Phone (270) 351-7200

Practitioners & affiliated clinicians

Practitioners 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1902770530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 WESTPORT RD STE A",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013832",
            "telephone_number": "270-234-1569",
            "fax_number": "270-234-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 EASTBROOKE POINTE DR E",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400477383",
            "telephone_number": "502-251-5145",
            "fax_number": "502-251-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-234-1569"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Washington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.