Provider Demographics
NPI:1598884322
Name:INSTITUTE OF REHAB HEALTH AND FITNE
Entity Type:Organization
Organization Name:INSTITUTE OF REHAB HEALTH AND FITNE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:913-681-0606
Mailing Address - Street 1:7213 W 161ST ST
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8879
Mailing Address - Country:US
Mailing Address - Phone:913-681-0606
Mailing Address - Fax:913-681-0605
Practice Address - Street 1:7213 W 161ST ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:KS
Practice Address - Zip Code:66085-8879
Practice Address - Country:US
Practice Address - Phone:913-681-0606
Practice Address - Fax:913-681-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS33465011OtherBLUE CROSS BLUE SHIELD KC
KSR230000Medicare ID - Type Unspecified