NPIMap

Organization Active NPI

Progressive Rehabilitation Orthopedic Therapy, Inc

  • Physical Therapy Clinic/Center
  • Lake Havasu City, AZ
National Provider Identifier
1922010602
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PROGRESSIVE REHABILITATION ORTHOPEDIC THERAPY, INC
Practice address
1948 Mesquite Ave
Suite 101
Lake Havasu City, AZ 86403-5777
Phone
(928) 854-4776
Fax
(928) 854-4857
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Authorized official

Name
Mr. John C Twomey, P.T.NPI 1245295294
Title
Director
Phone
(928) 854-4776

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 Primary

Addresses

Primary practice location

1948 Mesquite Ave
Suite 101
Lake Havasu City, AZ 86403-5777

Mailing address

1948 Mesquite Ave
Suite 101
Lake Havasu City, AZ 86403-5777
Phone (928) 854-4776

Other names 1

  • PROGRESSIVE REHABILITATION ORTHOPEDIC THERAPY Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623000591 AZ Part B Supplier - Clinic/Group Practice 6608851605 Receives reassigned benefits from 7 practitioners
Practice locations: Lake Havasu City, AZ

National Provider Directory

National Provider Directory

Locations

1795 Civic Center Blvd
#10
Lk Havasu Cty, AZ 86403
Phone (928) 854-4776

Practitioners & affiliated clinicians

Practitioners 7

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": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1922010602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 MESQUITE AVE",
            "address_2": "SUITE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035777",
            "telephone_number": "928-854-4776",
            "fax_number": "928-854-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 MESQUITE AVE",
            "address_2": "SUITE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035777",
            "telephone_number": "928-854-4776",
            "fax_number": "928-854-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE REHABILITATION ORTHOPEDIC THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "TWOMEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-854-4776",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROGRESSIVE REHABILITATION ORTHOPEDIC THERAPY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.