Provider Demographics
NPI:1427270768
Name:APEX PHYSICAL THERAPY CENTER, INC
Entity type:Organization
Organization Name:APEX PHYSICAL THERAPY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:765-661-4056
Mailing Address - Street 1:201 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-4030
Mailing Address - Country:US
Mailing Address - Phone:765-662-9905
Mailing Address - Fax:765-613-0108
Practice Address - Street 1:201 W 3RD ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-4030
Practice Address - Country:US
Practice Address - Phone:765-662-9905
Practice Address - Fax:765-613-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN5501012245208100000X
2081P0010X, 2081P2900X, 2081S0010X
IN05003874A261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200428410AMedicaid
IN200428410AMedicaid