| River Valley Therapy & Sports Medicine Inc | |
|
2100 W Main St, Russellville, AR 72801-2758 | |
| (479) 968-2525 | |
| (479) 968-2538 |
| Full Name | River Valley Therapy & Sports Medicine Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 2100 W Main St, Russellville, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619925732 | NPI | - | NPPES |
| DA9917 | Other | AR | PALMETTO GI RAILROAD |
| 5C556 | Other | AR | BLUE CROSS BLUE SHIELD |
| 662725 | Other | AR | HEALTHLINK |
| A001 | Other | AR | TRICARE |
| 145301742 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Christina M Bradford |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316996663 PECOS PAC ID: 4688576093 Enrollment ID: I20040126000398 |
| Provider Name | Michael D Beckham |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639183031 PECOS PAC ID: 0345234001 Enrollment ID: I20050105000479 |
| Provider Name | William D Morgan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053561464 PECOS PAC ID: 7416025291 Enrollment ID: I20081007000176 |
| Provider Name | Gabe Freyaldenhoven |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609825975 PECOS PAC ID: 9436052693 Enrollment ID: I20100616000896 |
| Provider Name | Heidi Lynn Person |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538460548 PECOS PAC ID: 7113116203 Enrollment ID: I20110105000270 |
| Provider Name | Natalie G Van Es |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215210810 PECOS PAC ID: 0143491910 Enrollment ID: I20110928000064 |
| Provider Name | Megan Nicole Goodwin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538437306 PECOS PAC ID: 2264609650 Enrollment ID: I20120126000226 |
| Provider Name | Marie R Charton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205163664 PECOS PAC ID: 7416192570 Enrollment ID: I20130321000218 |
| Provider Name | Gabriel Mayo Harris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669806485 PECOS PAC ID: 2264668490 Enrollment ID: I20131119000039 |
| Provider Name | Haley Mourot |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275933772 PECOS PAC ID: 4587886874 Enrollment ID: I20141121001236 |
| Provider Name | Jake Tyler Wallis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235682238 PECOS PAC ID: 8921395450 Enrollment ID: I20160927000449 |
| Provider Name | Scott Alan Bailey |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922556174 PECOS PAC ID: 0648559302 Enrollment ID: I20161121000815 |
| Provider Name | Kayley Foster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063968071 PECOS PAC ID: 2668752916 Enrollment ID: I20161205000011 |
| Provider Name | Annemieke D Corbitt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962926196 PECOS PAC ID: 8729354949 Enrollment ID: I20171016002089 |
| Provider Name | Angela J Bishop |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467979427 PECOS PAC ID: 7719244367 Enrollment ID: I20171227001540 |
| Provider Name | Rosemary Ellen Suggs |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770949752 PECOS PAC ID: 0345523825 Enrollment ID: I20181119000747 |
| Provider Name | Mabry Anne Keefe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134695125 PECOS PAC ID: 0941544134 Enrollment ID: I20181128002513 |
| Provider Name | Braden Scott Irwin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184197451 PECOS PAC ID: 8729326152 Enrollment ID: I20190211001869 |
| Provider Name | Amber B Allison |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760032585 PECOS PAC ID: 9830420140 Enrollment ID: I20191016003498 |
| Provider Name | John Tyler Goodpasture |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174171607 PECOS PAC ID: 9234460528 Enrollment ID: I20191017002464 |
| Provider Name | Carrie Herrmann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578235271 PECOS PAC ID: 8921497991 Enrollment ID: I20211112000489 |
| Provider Name | Jordin Betts |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881366573 PECOS PAC ID: 7012306566 Enrollment ID: I20211123000168 |
| Provider Name | Matthew Dallis Burgess |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891450409 PECOS PAC ID: 5890186787 Enrollment ID: I20220104001414 |
| Provider Name | Graycen Russell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316660921 PECOS PAC ID: 5597141283 Enrollment ID: I20221004001406 |
| Provider Name | Blake Austin Beck |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366218331 PECOS PAC ID: 0941647044 Enrollment ID: I20240325003844 |
| Mailing Address | Practice Location Address |
|---|---|
| River Valley Therapy & Sports Medicine Inc 2100 W Main St, Russellville, AR 72801-2758 Ph: (479) 968-2525 | River Valley Therapy & Sports Medicine Inc 2100 W Main St, Russellville, AR 72801-2758 Ph: (479) 968-2525 |
Seth B. Coulter, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 115 Skyline Dr, Suite A, Russellville, AR 72802 Phone: 479-967-5155 Fax: 479-967-5141 | |
Ms. Brandi Nicole Koch, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 Russell Rd, Russellville, AR 72802 Phone: 479-967-2316 Fax: 479-967-3639 | |
Jacqueline Miller, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 E 3rd St, Russellville, AR 72801 Phone: 479-968-1198 Fax: 479-967-1178 | |
Nicholas Paul Lensing, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 N Sidney Ave, Russellville, AR 72801 Phone: 479-890-5494 Fax: 479-967-0069 | |
Mr. Jerry Wayne Manning, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3016 W Main St Ste 200, Russellville, AR 72801 Phone: 479-967-9657 Fax: 479-967-9658 | |
Kimberly D Mcdougal, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 Reasoner Ln, Russellville, AR 72802 Phone: 479-970-2175 Fax: 479-964-2126 | |
Allison Young, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 E 3rd St, Russellville, AR 72801 Phone: 479-968-1198 |