NPIMap

Organization Active NPI

Trinity Rehabilitation Inc

  • Specialist
  • Springdale, AR
National Provider Identifier
1902910151
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TRINITY REHABILITATION INC
Practice address
1350 S Gutensohn Rd
Ste 10
Springdale, AR 72762-5117
Phone
(479) 751-7122
Fax
(479) 751-7292
NPI assigned
Aug 17, 2006
Last updated
Dec 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Mr. Kenneth L Ness, OTNPI 1942289384
Title
Therapist Partner Owner Director
Phone
(479) 751-7122

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
Specialist 174400000X Primary

Addresses

Primary practice location

1350 S Gutensohn Rd
Ste 10
Springdale, AR 72762-5117

Mailing address

1350 S Gutensohn Rd
Ste 10
Springdale, AR 72762-5210
Phone (479) 751-7122

Other identifiers 4

IdentifierTypeStateIssuer
129520741MedicaidAR
413388OtherARHEALTHLINK
5C037OtherARBLUE CROSS BLUE SHIELD
131922742MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040225001169 AR Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 8123914256 Practice locations: Bella Vista, AR; Fayetteville, AR; Springdale, AR
O20100930096825 AR DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 8123914256 Practice locations: Springdale, AR

National Provider Directory

National Provider Directory

Locations

9 Cunningham Cor
Bella Vista, AR 72714
Phone (479) 855-6814

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1902910151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S GUTENSOHN RD",
            "address_2": "STE 10",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625210",
            "telephone_number": "479-751-7122",
            "fax_number": "479-751-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S GUTENSOHN RD",
            "address_2": "STE 10",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625117",
            "telephone_number": "479-751-7122",
            "fax_number": "479-751-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "NESS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "THERAPIST PARTNER OWNER DIRECTOR",
        "authorized_official_telephone_number": "479-751-7122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129520741",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "413388",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C037",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131922742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.