RISE PHYSICAL THERAPY PA (NPI# 1104319433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104319433 |
| Entity Type | Organization |
| Organization Name | RISE PHYSICAL THERAPY PA |
| Other Organization Name | RISE PHYSICAL THERAPY PA |
| Practice Address |
3484 W Wedington Dr Ste 4 Fayetteville AR 72704 |
| Mailing Address |
2668 E Citizens Dr Ste 5 Fayetteville AR 72703-4796 |
| Practice Telephone | 4792395432 |
| Practice Fax Number | 4792395444 |
| Mailing Telephone | 4794427473 |
| Mailing Fax Number | 8448091417 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-07-20 |
| Authorized Official Name | TYLER GREEN (OWNER) |
| Authorized Official Telephone | 4792395432 |
| Authorized Official Credential | PT |
| Is Organization Subpart | Y |
| Parent Organization Name | RISE PHYSICAL THEARPY PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Rise Physical Therapy PA | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2668 E Citizens Dr, Fayetteville, AR 727034796 | 4794427483 | 4794427473 |
| Street Address |
3484 W WEDINGTON DR STE 4 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387037 | Anne-ashley Hull | Speech-Language Pathologist | 12905 Randolph Road, Fayetteville, AR 72704 | 2020-05-07 |
| 1427607019 | Destiny Bound, LLC | Midwife | 3825 N Salem Road, Fayetteville, AR 72704 | 2019-09-06 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1528410487 | Sharon Byrd | Licensed Practical Nurse | 17836 Harmon Rd, Fayetteville, AR 72704 | 2016-07-05 |
| 1861823502 | Andrea Warren | Pharmacist | 2875 W Martin Luther King Jr Blvd, Fayetteville, AR 72704 | 2013-12-05 |
| 1609157726 | Jessica Rose Collier | Speech-Language Pathologist | 2020 E Joyce Ave., Suite 2, Fayetteville, AR 72704 | 2011-09-02 |
| 1194044941 | Wcnc, Inc. | Skilled Nursing Facility | 4405 Persimmon Street, Fayetteville, AR 72704 | 2010-05-19 |
| 1841512944 | Jill K Johnston | Speech-Language Pathologist | 3472 N Sandpiper Dr, Fayetteville, AR 72704 | 2010-02-17 |
| 1922335876 | Nina Valencia Spearmon | Social Worker | 1958 N Batsford Dr, Fayetteville, AR 72704 | 2009-11-13 |
| Find all providers in zip 72704 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1578110813 | Encore Rehabilitation, Inc. | Clinic/Center | 1816 Huntsville Hwy, Fayetteville, TN 37334-3787 | 2019-08-21 |
| 1710490818 | Marianna Clo Hendrycy | Clinic/Center | 1830 N Crossover Rd, Fayetteville, AR 72701-2725 | 2017-11-10 |
| 1427218106 | Agape Sports Performance Wellness and Rehab | Clinic/Center | 402 Beckett Lane, Fayetteville, GA 30214 | 2008-06-16 |
| 1801446711 | Encore Rehabilitation, Inc. | Clinic/Center | 1816 Huntsville Hwy, Fayetteville, TN 37334-3787 | 2019-09-13 |
| 1245713080 | Held Rehabilitation Services, LLC | Clinic/Center | 500 Lanier Ave W Ste 702, Fayetteville, GA 30214-7643 | 2018-09-07 |
| 1407343502 | Occupational Health Centers of North Carolina, PC | Clinic/Center | 1702 Owen Dr, Fayetteville, NC 28304-3419 | 2018-04-16 |
| 1851743009 | Rise Physical Therapy, P.a. | Clinic/Center | 2668 E Citizens Dr Ste 5, Fayetteville, AR 72703 | 2016-07-11 |
| 1427330737 | Select Physical Therapy | Clinic/Center | 2550 Ravenhill Dr, Fayetteville, NC 28303-9627 | 2011-09-13 |
| 1518262682 | Brubaker Physical Therapy, LLC | Clinic/Center | 245 Lodge Trl, Fayetteville, GA 30215-7626 | 2011-01-20 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
Please comment or provide details below to improve the information on RISE PHYSICAL THERAPY PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.