ELITE REHAB LLC
NPI 1205792850
Physical Therapist in Kirksville, MO

Active since December 29, 2025
616 E SHEPHERD AVE, KIRKSVILLE, MO 63501(660) 956-9925(660) 956-9924 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 28, 2026, Dec 29, 2025 (2 updates tracked since 2025).

About Elite Rehab Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELITE REHAB LLC (NPI 1205792850) is a healthcare organization registered as a physical therapist in Kirksville, Missouri and active in the NPI registry since December 2025. The organization lists Brandon Lee Mack, Owner, as its authorized official.

NPPES Registry Identity

NPI1205792850
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameELITE REHAB LLC
Location Address616 E SHEPHERD AVEKirksville, MO 63501-4711
Mailing Address616 E Shepherd AveKirksville, MO 63501-4711 · (660) 956-9925 · Fax (660) 956-9924
Fax(660) 956-9924
Organization SubpartNo
Authorized OfficialBrandon Lee MackOwner · (660) 956-9925
Enumeration DateDecember 29, 2025
Last NPPES UpdateApril 28, 20262 updates tracked since enumeration
NPPES CertifiedApril 28, 2026
✔ NPI 1205792850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
616 E SHEPHERD AVE, Kirksville, MO 63501

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elite Rehab Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Elite Rehab LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Physical Therapist in Private Practice
NPI 1134188832
JUNCTION S. HWY 63 & 6E OUTPATIENT PHYSICAL THERAPY
Kirksville, MO 63501
(660) 785-1834
✔ Accepts Medicare12 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elite Rehab LLC's NPI number?

The NPI number for Elite Rehab LLC is 1205792850. It was assigned to this organization in the NPPES registry on December 29, 2025.

Where is Elite Rehab LLC located?

Elite Rehab LLC is located at 616 E Shepherd Ave, Kirksville, MO 63501. The listed phone number is (660) 956-9925.

What is Elite Rehab LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Elite Rehab LLC enrolled in Medicare?

Yes. Elite Rehab LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Elite Rehab LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Elite Rehab LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Elite Rehab LLC was last updated on April 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.