NPIMap

Organization Active NPI

Monticello Physical Therapy Inc

  • Physical Therapist
  • Monticello, KY
National Provider Identifier
1982686887
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MONTICELLO PHYSICAL THERAPY INC
Practice address
One Southcreek Dr
Suite 116
Monticello, KY 42633-9472
Phone
(606) 348-3314
Fax
(606) 348-3315
NPI assigned
Nov 16, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Samuel M Brown, PTNPI 1740262112
Title
Owner
Phone
(606) 348-3314

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X KY Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

One Southcreek Dr
Suite 116
Monticello, KY 42633-9472

Mailing address

1 S Creek Dr
Suite 116
Monticello, KY 42633-9472
Phone (606) 348-3314

Other identifiers 1

IdentifierTypeStateIssuer
87900353MedicaidKY

Other names 1

  • Wayne County Physical Therapy Clinic Other name

National Provider Directory

National Provider Directory

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": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982686887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S CREEK DR",
            "address_2": "SUITE 116",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339472",
            "telephone_number": "606-348-3314",
            "fax_number": "606-348-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE SOUTHCREEK DR",
            "address_2": "SUITE 116",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339472",
            "telephone_number": "606-348-3314",
            "fax_number": "606-348-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-348-3314",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87900353",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne County Physical Therapy Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monticello, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.