NPIMap

Organization Active NPI

Deborah a Mitchell Physical Therapy, LLC

Doing business as Red Rock Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • McHenry, IL
National Provider Identifier
1912342429
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
70013347 Issued in IL
Legal business name
DEBORAH A MITCHELL PHYSICAL THERAPY, LLC
Doing business as
Red Rock Physical Therapy and Wellness
Practice address
5435 Bull Valley Rd
Suite 110
McHenry, IL 60050-7434
Phone
(815) 451-4502
NPI assigned
May 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Authorized official

Name
Dr. Deborah A Mitchell, PTNPI 1417975566
Title
Physical Therapist
Phone
(815) 451-4502

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 Therapy Clinic/Center 261QP2000X 70013347 IL Primary

Addresses

Primary practice location

5435 Bull Valley Rd
Suite 110
McHenry, IL 60050-7434

Mailing address

5435 Bull Valley Rd
Suite 110
McHenry, IL 60050-7434
Phone (815) 451-4502

Other names 1

  • Red Rock Physical Therapy and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130524000638 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860630225 Receives reassigned benefits from 4 practitioners
Practice locations: McHenry, IL

National Provider Directory

National Provider Directory

Locations

5435 Bull Valley Rd
Ste 11
McHenry, IL 60050

5435 Bull Valley Rd
Ste 110
McHenry, IL 60050
Phone (815) 354-9916

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1912342429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 BULL VALLEY RD",
            "address_2": "SUITE 110",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507434",
            "telephone_number": "815-451-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 BULL VALLEY RD",
            "address_2": "SUITE 110",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600507434",
            "telephone_number": "815-451-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH A MITCHELL PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "815-451-4502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "70013347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Rock Physical Therapy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.