PERMIAN BASIN REHABILITATION CENTER FOR CRIPPLED CHILDREN AND ADULTS (NPI# 1104958701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104958701 |
| Entity Type | Organization |
| Organization Name | PERMIAN BASIN REHABILITATION CENTER FOR CRIPPLED CHILDREN AND ADULTS |
| Practice Address |
620 N Alleghaney Ave Odessa TX 79761-4408 |
| Practice Telephone | 4323328244 |
| Practice Fax Number | 4325807428 |
| Mailing Telephone | 4323328244 |
| Mailing Fax Number | 4325807428 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | JOHN WADE KUEHLER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4323328244 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities | ||
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS HEARING AID ID NUM | 531269 | 01 |
| TX | 094460501 | 05 | |
| TX | AETNA BILLING NUM | 5589378 | 01 |
| TX | BCBS GROUP NUMBER | 051CT | 01 |
| Street Address |
620 N ALLEGHANEY AVE |
| City | ODESSA |
| State | TX |
| Zip Code | 79761-4408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020313 | Vanessa Kay Zoelzer | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2020-07-13 |
| 1487276283 | Erin Kimmel | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2020-05-14 |
| 1932721750 | Helen Cramm | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2020-05-14 |
| 1295368512 | Laura Leigh Venesky | Occupational Therapist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2020-02-14 |
| 1801355755 | Katie Elizabeth Garza | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2019-03-19 |
| 1104315357 | Caroline Mccrary | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2018-05-03 |
| 1073028395 | Leigha Justine Perkins | Occupational Therapist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2017-12-08 |
| 1548770183 | Rachel Christian | Occupational Therapist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2017-10-10 |
| 1205352580 | Alyssa Nabarrette | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761 | 2017-08-17 |
| 1841745130 | Bonnie Wright | Speech-Language Pathologist | 620 N Alleghaney Ave, Odessa, TX 79761-4408 | 2016-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482003 | Endovascular Lab Pllc | Surgery | 612 N Washington Avenue, Suite 100, Odessa, TX 79761 | 2020-03-16 |
| 1235627605 | Megan Elizabeth Lemond | Pediatrics | 912 E 5th St, Odessa, TX 79761 | 2018-05-01 |
| 1922522630 | Brian W Griffin | Nurse Practitioner | 4606 Fountain Ln., Odessa, TX 79761 | 2017-08-03 |
| 1023540507 | Florenda De Guzman | Nurse Practitioner | 405 N Tom Green, Odessa, TX 79761 | 2017-04-03 |
| 1205378239 | Scotty R Ortega Md | Clinical Nurse Specialist | 2487 E 11th Street, Odessa, TX 79761 | 2016-11-08 |
| 1487094355 | Marivel Perez | Nurse Practitioner | 540 W 5th St Ste 350, Ste. 350, Odessa, TX 79761 | 2013-06-25 |
| 1245579804 | Accurate Health Care LLC | Home Health | 302 Industrial Ave, Odessa, TX 79761 | 2013-02-01 |
| 1437421666 | Mary Magdalene Garcia | Speech-Language Pathologist | 620 N. Alleghaney, Odessa, TX 79761 | 2012-02-03 |
| 1841576378 | Ashley Burdex | Family Medicine | 6030 W University, Odessa, TX 79761 | 2011-10-28 |
| 1730465428 | Therese A Archer | Massage Therapist | 712 N. Texas Ave, Odessa, TX 79761 | 2011-10-26 |
| Find all providers in zip 79761 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346641727 | Ascend Rehab LLC | Clinic/Center | 1330 E 8th St, 111, Odessa, TX 79761-4702 | 2014-09-04 |
| 1073601670 | Synergy Physical Therapy of Odessa Lp | Clinic/Center | 808 Tower Dr, Suite 7, Odessa, TX 79761-4243 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807615 | Rise Up Rehab, LLC | Clinic/Center | 1687 Old Hwy 90, Castroville, TX 78009 | 2019-08-22 |
| 1346897709 | Rise Up Rehab, LLC | Clinic/Center | 10410 Parrigin Rd, Helotes, TX 78023-4283 | 2019-08-21 |
| 1376016410 | Elite 360 Health and Wellness | Clinic/Center | 1409 S Lamar, Ste. 245, Dallas, TX 75215-6818 | 2019-01-10 |
| 1902333792 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 21004 Interstate 45 N, Spring, TX 77373-2917 | 2017-05-11 |
| 1023544418 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 5095 Preston Ave, Pasadena, TX 77505-2053 | 2017-05-04 |
| 1871029264 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 4818 E Sam Houston Pkwy N, Houston, TX 77015-3240 | 2017-05-04 |
| 1356793509 | Individual | Clinic/Center | 3500 Timberwood Cir Apt 2137, Arlington, TX 76015-3129 | 2016-07-11 |
| 1801242839 | Transitional Learning Center At Galveston | Clinic/Center | 4416 10th St, Lubbock, TX 79416-4800 | 2016-05-09 |
| 1225401805 | Milestones | Clinic/Center | 2704 S 26th St, Mcallen, TX 78503-7812 | 2015-11-04 |
| 1326421173 | Costa Therapy Institute, LLC | Clinic/Center | 1058 Palm Blvd, Brownsville, TX 78520-6168 | 2015-06-29 |
| Find all providers with the same taxonomy | ||||
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| 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.