MEDICARE: PRIORITY WELLNESS AND REHAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225200000X	Physical Therapy Assistant
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist
5	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1326686049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIORITY WELLNESS AND REHAB LLC

Provider Business Mailing Address
First Line	:	2070 W 106TH ST
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-7918
Country	:	US
Telephone Number	:	317-652-1584
Fax Number	:

Provider Business Practice Location Address
First Line	:	1703 W 86TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2076
Country	:	US
Telephone Number	:	317-688-7560
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HARISHANTHAN S. NAGRIDDY
Credential	:
Telephone Number	:	317-652-1584

Provider Enumeration Date	:	12/12/2019
Last Update Date	:	03/13/2023

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