PHOENIX REHAB GROUP LLC NPI 1841261914

NPI Information

NPI: 1841261914
Provider Name: PHOENIX REHAB GROUP, LLC
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
1600 SCOTTSVILLE RD
SUITE 101
BOWLING GREEN, KY
ZIP 42104
Phone: (270) 781-0028
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PHOENIX REHAB GROUP, LLC is a rehabilitation clinic center in Bowling Green, KY. PHOENIX REHAB GROUP, LLC NPI is 1841261914. The provider is registered as an organization entity type.

The provider's business location address is:

1600 SCOTTSVILLE RD
SUITE 101
BOWLING GREEN, KY
ZIP 42104-217
Phone: (270) 781-0028
Fax: (270) 781-0007

The provider's authorized official is Brad Norman .
The authorized official title is Administrator and has the following contact phone number (270) 781-0028.

The enumeration date for this NPI number is 1/27/2006 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	101011	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000375301	OTHER	KENTUCKY	ANTHEM GROUP PT
2	=========	OTHER	KENTUCKY	INTEGRATED HEALTH PLAN
3	000000337293	OTHER	KENTUCKY	ANTHEM GROUP OT
4	993500	MEDICARE OSCAR/CERTIFICATION	KENTUCKY
5	=========	OTHER	KENTUCKY	BLUEGRASS FAMILY HEALTH
6	000000375294	OTHER	KENTUCKY	ANTHEM GROUP SLP
7	186616	MEDICARE OSCAR/CERTIFICATION	KENTUCKY
8	=========	OTHER	KENTUCKY	HUMANA
9	=========	OTHER	KENTUCKY	TRICARE FOR LIFE
10	DE3129	MEDICARE OSCAR/CERTIFICATION	KENTUCKY
11	2224590	OTHER	KENTUCKY	FIRST HEALTH
12	91000042	MEDICAID	KENTUCKY
13	88900071	MEDICAID	KENTUCKY
14	87900817	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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