CHAMPION PHYSICAL THERAPY KENTUCKY, LLC (NPI# 1720589724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720589724 |
| Entity Type | Organization |
| Organization Name | CHAMPION PHYSICAL THERAPY KENTUCKY, LLC |
| Other Organization Name | CORA PHYSICAL THERAPY - MIDDLESBORO |
| Practice Address |
1475 Us Highway 25 E Ste 6 Middlesboro KY 40965-2077 |
| Mailing Address |
1110 Shawnee Rd Lima OH 45805-3529 |
| Practice Telephone | 6062481996 |
| Practice Fax Number | 6062481901 |
| Mailing Telephone | 4192216717 |
| Mailing Fax Number | 4192220507 |
| Enumeration Date | 2018-02-24 |
| Last Update Date | 2018-09-13 |
| Authorized Official Name | MR. BRAD C. ROUSH (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Telephone | 4192216712 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Champion Physical Therapy | Doing Business As Name - Organization |
| CORA Physical Therapy - Middlesboro | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 103 S Pine St, Pineville, KY 409771610 | 6062542075 | 6062194251 |
| 2835 S Highway 27, Somerset, KY 425013042 | 6063022831 | 6066873152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689150682 | Champion Physical Therapy Kentucky, LLC | Clinic/Center | 2835 S Highway 27 Ste 286b, Somerset, KY 42501-3062 | 2018-07-13 |
| 1114403060 | Champion Physical Therapy Kentucky, LLC | Clinic/Center | 1475 Us Highway 25 E Ste 6, Middlesboro, KY 40965-2077 | 2018-07-13 |
| 1588140586 | Champion Physical Therapy Kentucky, LLC | Clinic/Center | 103 S Pine St, Pineville, KY 40977-1610 | 2018-07-13 |
| Street Address |
1475 US HIGHWAY 25 E STE 6 |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-2077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114403060 | Champion Physical Therapy Kentucky, LLC | Clinic/Center | 1475 Us Highway 25 E Ste 6, Middlesboro, KY 40965-2077 | 2018-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114403060 | Champion Physical Therapy Kentucky, LLC | Clinic/Center | 1475 Us Highway 25 E Ste 6, Middlesboro, KY 40965-2077 | 2018-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070363 | Kentucky Rehabilitation Services Inc | Clinic/Center | 2010 N Bend Rd, Hebron, KY 41048-8003 | 2020-10-14 |
| 1740809045 | Sn Kentuckiana Rehab, LLC | Clinic/Center | 3509 S Hurstbourne Pkwy, Louisville, KY 40299-1364 | 2020-04-16 |
| 1568001493 | Champion Physical Therapy Kentucky LLC | Clinic/Center | 440 W Cumberland Gap Pkwy, Corbin, KY 40701-4819 | 2019-12-23 |
| 1942843610 | Uofl Health-louisville Inc | Clinic/Center | 6801 Dixie Hwy # 189, Louisville, KY 40258-3913 | 2019-10-24 |
| 1942843602 | Uofl Health-louisville Inc | Clinic/Center | 100 High Rise Dr Ste 110, Louisville, KY 40213-3251 | 2019-10-24 |
| 1891338554 | Uofl Health-louisville Inc | Clinic/Center | 1905 W Hebron Ln Ste 106, Shepherdsville, KY 40165-7466 | 2019-10-24 |
| 1033752704 | Uofl Health-louisville Inc | Clinic/Center | 3430 Newburg Rd Ste 111a, Louisville, KY 40218-2497 | 2019-10-24 |
| 1962045625 | Uofl Health-louisville Inc | Clinic/Center | 4912 Us Highway 42 Ste 104, Louisville, KY 40222-6357 | 2019-10-24 |
| 1679116347 | Uofl Health-louisville Inc | Clinic/Center | 2401 Terra Crossing Blvd # 204, Louisville, KY 40245-5395 | 2019-10-24 |
| 1104469873 | Uofl Health-louisville Inc | Clinic/Center | 4801 Olympia Park Plz Ste 1600, Louisville, KY 40241-2095 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
Please comment or provide details below to improve the information on CHAMPION PHYSICAL THERAPY KENTUCKY, LLC.
| 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.