Provider Demographics
NPI:1740393057
Name:NEW CPT & R, INC.
Entity Type:Organization
Organization Name:NEW CPT & R, INC.
Other - Org Name:COMMONWEALTH PHYSICAL THERAPY AND REHABILITATION- GEORGETOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:859-278-2121
Mailing Address - Street 1:PO BOX 911148
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1148
Mailing Address - Country:US
Mailing Address - Phone:859-278-2121
Mailing Address - Fax:859-276-1649
Practice Address - Street 1:107 FRAZIER CT
Practice Address - Street 2:SUITE 102
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8973
Practice Address - Country:US
Practice Address - Phone:502-570-5854
Practice Address - Fax:502-570-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000389107OtherANTHEM PT PROVIDER NUMBER
KY000000389107OtherANTHEM PT PROVIDER NUMBER