SERC REHABILITATION PARTNERS LLC (NPI# 1114421922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114421922 |
| Entity Type | Organization |
| Organization Name | SERC REHABILITATION PARTNERS LLC |
| Other Organization Name | SERC - FAYETTEVILLE, AR |
| Practice Address |
1261 N Steamboat Dr Ste 2 Fayetteville AR 72704-6262 |
| Mailing Address |
6397 Lee Hwy Ste 300 Chattanooga TN 37421-2564 |
| Practice Telephone | 4793136591 |
| Practice Fax Number | 4793137650 |
| Mailing Telephone | 4232387217 |
| Mailing Fax Number | 4232383473 |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |
| Authorized Official Name | KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS) |
| Authorized Official Telephone | 4232382313 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| Y | 225100000X | Physical Therapist | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| SERC - Fayetteville, AR | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669029468 | Serc Rehabilitation Partners LLC | Occupational Therapist | 13011 E 21st St N Ste 107, Wichita, KS 67230-7407 | 2019-08-26 |
| 1962980037 | Serc Rehabilitation Partners LLC | Occupational Therapist | 200 E Morrow St, Ste 1, Marshall, MO 65340-3326 | 2018-08-01 |
| 1912436627 | Serc Rehabilitation Partners LLC | Occupational Therapist | 11902 Blue Ridge Ext Ste 11906b, Grandview, MO 64030-1100 | 2017-06-06 |
| 1669905139 | Serc Rehabilitation Partners LLC | Clinic/Center | 2108 W 27th St, Ste K, Lawrence, KS 66047-3153 | 2017-04-11 |
| 1861823403 | Serc Rehabilitation Partners LLC | Clinic/Center | 3627 Se 29th St, Ste 107, Topeka, KS 66605-2013 | 2013-12-09 |
| 1447699244 | Serc Rehabilitation Partners LLC | Occupational Therapist | 13847 W 63rd St Ste 2, Shawnee, KS 66216-3800 | 2013-06-14 |
| 1770826471 | Serc Rehabilitation Partners LLC | Occupational Therapist | 19310 E 50th Ter S Ste A, Independence, MO 64055-5564 | 2013-04-01 |
| 1356695035 | Serc Rehabilitation Partners LLC | Occupational Therapist | 578 E Harrison St, Republic, MO 65738-1353 | 2012-11-02 |
| 1033473434 | Serc Rehabilitation Partners LLC | Occupational Therapist | 12755 S Mur Len Rd, Ste B1, Olathe, KS 66062-6804 | 2012-06-29 |
| 1760746291 | Serc Rehabilitation Partners LLC | Occupational Therapist | 1227 E 32nd St Ste 7, Joplin, MO 64804-2904 | 2012-06-29 |
| Street Address |
1261 N STEAMBOAT DR STE 2 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72704-6262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770046039 | Jacob Thomas Davies | Physical Therapist | 1261 N Steamboat Dr Ste 2, Fayetteville, AR 72704-6262 | 2019-04-12 |
| 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 |
| 1104319433 | Rise Physical Therapy Pa | Clinic/Center | 3484 W Wedington Dr Ste 4, Fayetteville, AR 72704 | 2018-06-12 |
| 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 |
| Find all providers in zip 72704 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602178 | Ryan Matthew Derby | Physical Therapist | 1191 Fordham Drive, Suite 102, Fayetteville, NC 28304-3774 | 2020-09-03 |
| 1649882705 | P4 Physical Therapy - Fayetteville, LLC | Physical Therapist | 1229 Huntsville Hwy Ste B, Fayetteville, TN 37334-3685 | 2020-08-20 |
| 1295352136 | Jessica Czarnecki | Physical Therapist | 2668 E Citizens Dr Ste 4, Fayetteville, AR 72703-4796 | 2020-06-26 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1245870187 | Patricia Jean Boehlert | Physical Therapist | 4401 Medical Center Dr Ste 401, Fayetteville, NY 13066-6603 | 2020-01-08 |
| 1427691617 | Brandon Merrick | Physical Therapist | 13917 Hickory Trce, Fayetteville, AR 72704-8417 | 2019-10-21 |
| 1841847936 | Abigail Weiskopf | Physical Therapist | 2350 Bentridge Ln Suite 102, Fayetteville, NC 28304-0591 | 2019-08-22 |
| 1932755766 | Jonathan Cole Vaughn | Physical Therapist | 2793 E Millennium Pl Ste 2, Fayetteville, AR 72703-6522 | 2019-08-16 |
| 1205395944 | Sharon Branch | Physical Therapist | 125 Franklin Farms Cir, Fayetteville, GA 30214-3361 | 2019-03-12 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
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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.