NPIMap

Organization Active NPI

Ironton Physical Therapy Inc

Doing business as Tri State Rehab Services

  • Physical Therapist
  • Huntington, WV
National Provider Identifier
1013036011
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IRONTON PHYSICAL THERAPY INC
Doing business as
Tri State Rehab Services
Practice address
4120 Waverly Rd
Huntington, WV 25704-1127
Phone
(304) 429-7381
Fax
(304) 429-7383
NPI assigned
Mar 29, 2007
Last updated
Mar 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Beverly Shae Ritchey
Title
Office Manager
Phone
(606) 324-0540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4120 Waverly Rd
Huntington, WV 25704-1127

Mailing address

2700 Greenup Ave
Ashland, KY 41101-1953
Phone (606) 324-0540

Other identifiers 2

IdentifierTypeStateIssuer
2632244MedicaidOH
3810004569MedicaidWV

Other names 1

  • Tri State Rehab Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040114000247 WV Part B Supplier - Clinic/Group Practice 0749188407 Receives reassigned benefits from 5 practitioners
Practice locations: Huntington, WV

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ironton Physical Therap6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2700 Greenup Ave
Ashland, KY 41101
Phone (606) 324-0540

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1013036011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 GREENUP AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411011953",
            "telephone_number": "606-324-0540",
            "fax_number": "606-324-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 WAVERLY RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257041127",
            "telephone_number": "304-429-7381",
            "fax_number": "304-429-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRONTON PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "RITCHEY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "SHAE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-324-0540"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2632244",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004569",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri State Rehab Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.