NPIMap

Organization Active NPI

Prorehab of Louisville, LLC

  • Physical Therapy Clinic/Center
  • Louisville, KY
National Provider Identifier
1952060485
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PROREHAB OF LOUISVILLE, LLC
Practice address
4042 Dutchmans LN
Louisville, KY 40207-4712
Phone
(502) 899-9363
Fax
(502) 899-9365
NPI assigned
Dec 13, 2021
Last updated
Mar 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Andrea L. Baumann
Title
Coo
Phone
(812) 759-7473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

4042 Dutchmans LN
Louisville, KY 40207-4712

Mailing address

PO Box 5629
Evansville, IN 47716-5629
Phone (812) 401-3258

Other identifiers 1

IdentifierTypeStateIssuer
1952060485MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150316002327 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4587981337 Receives reassigned benefits from 72 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prospect, KY; Louisville, KY; Crestwood, KY; Jeffersontown, KY; La Grange, KY

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Prorehab Louisville LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 1

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": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1952060485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5629",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477165629",
            "telephone_number": "812-401-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4042 DUTCHMANS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074712",
            "telephone_number": "502-899-9363",
            "fax_number": "502-899-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB OF LOUISVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "BAUMANN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "812-759-7473"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952060485",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.