Blue Rose Physical Therapy - West Little Rock Llc is a medicare enrolled "Clinic/center - Physical Therapy" provider in Little Rock, Arkansas. Their current practice location is
1 Huntington Rd, Little Rock, Arkansas. You can reach out to their office (for appointments etc.) via phone at
(501) 904-2778.
Blue Rose Physical Therapy - West Little Rock Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Blue Rose Physical Therapy - West Little Rock Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1003636630.
Healthcare Provider's Profile
| Full Name | Blue Rose Physical Therapy - West Little Rock Llc |
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| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 1 Huntington Rd, Little Rock, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003636630
- Provider Enumeration Date: 10/17/2024
- Last Update Date: 11/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 8022545862
- Enrollment ID: O20241218001813
Medical Identifiers
Medical identifiers for Blue Rose Physical Therapy - West Little Rock Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003636630 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Blue Rose Physical Therapy - West Little Rock Llc acts as a billing entity for following providers:
| Provider Name | Logan Dockery |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1609442250
PECOS PAC ID: 2668860024
Enrollment ID: I20211104000830 |
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| Provider Name | Tyler Lee Graham |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1871074666
PECOS PAC ID: 3971970153
Enrollment ID: I20221031002798 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blue Rose Physical Therapy - West Little Rock Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Blue Rose Physical Therapy - West Little Rock Llc
Po Box 15538,
Little Rock, AR 72231-5538
Ph: () - | Blue Rose Physical Therapy - West Little Rock Llc
1 Huntington Rd,
Little Rock, AR 72227-2306
Ph: (501) 904-2778 |
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