NPIMap

Organization Active NPI

Champion Physical Therapy & Athletic Rehabilitation, PC

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1982613527
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1906 Issued in NE
Legal business name
CHAMPION PHYSICAL THERAPY & ATHLETIC REHABILITATION, PC
Practice address
10700 Sapp Brothers Dr
Omaha, NE 68138-3823
Phone
(402) 203-1872
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Authorized official

Name
Mr. Brian D Long, PT/ATCNPI 1013925189
Title
President
Phone
(402) 203-1872

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1906 NE Primary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X 375 NE

Addresses

Primary practice location

10700 Sapp Brothers Dr
Omaha, NE 68138-3823

Mailing address

10700 Sapp Brothers Dr
Omaha, NE 68138-3823
Phone (402) 203-1872

Other identifiers 2

IdentifierTypeStateIssuer
02148OtherNEBLUE CROSS BLUE SHEILD
10025424600MedicaidNE

National Provider Directory

National Provider Directory

Locations

10700 Sapp Brothers Dr
Omaha, NE 68138
Phone (402) 210-1472

Practitioners & affiliated clinicians

Practitioners 1

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1982613527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 SAPP BROTHERS DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681383823",
            "telephone_number": "402-203-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SAPP BROTHERS DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681383823",
            "telephone_number": "402-203-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION PHYSICAL THERAPY & ATHLETIC REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-203-1872",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT/ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1906",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NE",
            "license": "375",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "02148",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025424600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.