OMNIS REHAB L.L.C (NPI# 1699143321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699143321 |
| Entity Type | Organization |
| Organization Name | OMNIS REHAB L.L.C |
| Other Organization Name | OMNIS REHAB |
| Practice Address |
12120 Colonel Glenn Rd Ste 5200 Little Rock AR 72210-2824 |
| Mailing Address |
12721 Meadows Edge Ln Little Rock AR 72211-4443 |
| Practice Telephone | 5014544528 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |
| Authorized Official Name | DR. REX PAUL BRADY DECLERK (OWNER) |
| Authorized Official Telephone | 5014544528 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 15639 | AR | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Omnis Rehab | Doing Business As Name - Organization |
| Street Address |
12120 COLONEL GLENN RD STE 5200 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72210-2824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1972159267 | Arkansas Baptist Children's Homes and Family Ministries | Counselor | 12400 I-30, Little Rock, AR 72210 | 2019-08-13 |
| 1952956864 | Hanrietta Evans | Behavior Technician | Youth Home Inc, 20302 Colonel Glenn Rd, Little Rock, AR 72210 | 2019-08-07 |
| 1821597287 | Deanna Smith | Counselor | 12320 I-30 Frontage Road, Little Rock, AR 72210 | 2018-02-12 |
| 1922485481 | Whitney Brown | Social Worker | 20400 Colonel Glenn, Little Rock, AR 72210 | 2015-05-04 |
| 1679978191 | Jennifer Black | Counselor | 20302 Col Glenn Road, Little Rock, AR 72210 | 2014-10-27 |
| 1831593896 | James William Takach | Family Medicine | 14519 Wimbledon Loop, Little Rock, AR 72210 | 2014-10-20 |
| 1811319734 | Ben Malone | Case Manager/Care Coordinator | 20400 Col Glenn Road, Little Rock, AR 72210 | 2014-01-12 |
| 1487924296 | Tara Brown | Case Manager/Care Coordinator | 20302 Colonel Glenn Rd., Little Rock, AR 72210 | 2012-01-10 |
| 1972889061 | D. Rachelle Rial | Case Manager/Care Coordinator | 20400 Col Glenn Rd., Little Rock, AR 72210 | 2011-11-02 |
| Find all providers in zip 72210 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376159848 | Seh Holdings, Pllc | Chiropractor | 13924 Cantrell Rd Ste C, Little Rock, AR 72223-1508 | 2020-09-21 |
| 1124672100 | Maddison Ganann | Chiropractor | 14300 Cantrell Rd Ste 110, Little Rock, AR 72223-4698 | 2019-07-29 |
| 1386102242 | Tyler Edward Hicks | Chiropractor | 14300 West Cantrell Rd Suite 10, Little Rock, AR 72223 | 2019-03-08 |
| 1740746049 | Dustin Worthen | Chiropractor | 15400 Chenal Pkwy Ste 120, Little Rock, AR 72211-2297 | 2019-02-12 |
| 1497245427 | Regenerative Medical Associates of Arkansas | Chiropractor | 11219 Financial Centre Pkwy Ste 215, Little Rock, AR 72211-3867 | 2018-05-15 |
| 1982112793 | Keith Beachy | Chiropractor | 12911 Cantrell Rd Ste 4, Little Rock, AR 72223-1710 | 2018-01-15 |
| 1912436825 | Justin Collier | Chiropractor | 11525 Cantrell Rd Ste 301, Little Rock, AR 72212-1713 | 2017-06-06 |
| 1629528112 | Xuan Yi | Chiropractor | 2723 Foxcroft Rd Ste 103, Little Rock, AR 72227-6511 | 2016-10-07 |
| 1912303975 | Rock City Chiropractic Pllc | Chiropractor | 3000 Kavanaugh Blvd Ste A, Little Rock, AR 72205-3700 | 2014-11-18 |
| 1295151504 | Properly Aligned LLC | Chiropractor | 7117 Geyer Springs, Little Rock, AR 72209 | 2014-03-11 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72210 |
Please comment or provide details below to improve the information on OMNIS REHAB L.L.C.
| 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.