NPIMap

Organization Active NPI

Prorehab, Inc

  • Physical Therapy Clinic/Center
  • Henderson, KY
National Provider Identifier
1972765386
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
101107 Issued in KY
Legal business name
PROREHAB, INC
Practice address
702 Barrett Blvd
Suite B
Henderson, KY 42420-4931
Phone
(270) 631-4100
Fax
(270) 631-4101
NPI assigned
Jun 26, 2008
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Physical Therapy Clinic/Center 261QP2000X 101107 KY Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

702 Barrett Blvd
Suite B
Henderson, KY 42420-4931

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (812) 401-3258

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180712001913 KY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254317217 Receives reassigned benefits from 21 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowling Green, KY; Henderson, KY

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Laura M Happe TR19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1972765386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "812-401-3258",
            "fax_number": "812-401-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BARRETT BLVD",
            "address_2": "SUITE B",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204931",
            "telephone_number": "270-631-4100",
            "fax_number": "270-631-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "KY",
            "license": "101107",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.