Provider Demographics
NPI:1649218306
Name:APEX PHYSICAL THERAPY AND REHABILITATION, PLLC
Entity Type:Organization
Organization Name:APEX PHYSICAL THERAPY AND REHABILITATION, PLLC
Other - Org Name:APEX PHYSICAL THERAPY AND REHABILITATION, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, COMT
Authorized Official - Phone:502-245-1136
Mailing Address - Street 1:175 S ENGLISH STATION RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-4160
Mailing Address - Country:US
Mailing Address - Phone:502-245-1136
Mailing Address - Fax:502-245-1146
Practice Address - Street 1:175 S ENGLISH STATION RD
Practice Address - Street 2:SUITE 220
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-4160
Practice Address - Country:US
Practice Address - Phone:502-245-1136
Practice Address - Fax:502-245-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000345888OtherANTHEM GROUP #
KYDD2674OtherRAILROAD RETIREMENT BOARD
9425OtherMEDICARE GROUP #
KYDD2674OtherPALMETTO GBA RAILROAD MEDICARE
KY057126706OtherKY STATE LICENSE