Choice Physical Therapy Southwest LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CHOICE PHYSICAL THERAPY SOUTHWEST LLC

Practice address

212 E Main St
North Manchester, IN 46962-1823

Phone

(260) 797-2572

NPI assigned

Apr 21, 2025

Last updated

May 11, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrew WagnerNPI 1427130814

Title

Owner

Phone

(260) 797-2572

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

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.

• Andrew Thomas Wagner, PT ATC

  • Physical Therapist
  • Leo, IN
  • NPI 1427130814
  Medicare reassignment Care Compare group NPD Authorized official
• Konner Platt, PT, DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fort Wayne, IN
  • NPI 1346005170
  Medicare reassignment Care Compare group NPD
• Brian William Roth, MPT

  • Physical Therapist
  • Auburn, IN
  • NPI 1033285846
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1992591416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6863 HOLLOPETER RD",
            "city": "LEO",
            "state": "IN",
            "postal_code": "467659269",
            "telephone_number": "260-797-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E MAIN ST",
            "city": "NORTH MANCHESTER",
            "state": "IN",
            "postal_code": "469621823",
            "telephone_number": "260-797-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE PHYSICAL THERAPY SOUTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-21",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-797-2572"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bazzoni
• Bradley S Camp, O.D.
• Brayden Casper, DC
• Russell Glendon Coulter-Kern, PH.D.
• Joel Eikenberry, M.D.
• Family Hearing Center, Inc
• Erin R Foreman, ATC, LAT
• Paul H. Fry-Miller, PA-C

• Physical Therapy Clinic/Center in North Manchester, IN
• Providers in North Manchester, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.