NPIMap

Organization Active NPI

Replay Physical Therapy

  • Physical Therapy Clinic/Center
  • Kokomo, IN
National Provider Identifier
1043267289
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
REPLAY PHYSICAL THERAPY
Practice address
2122 S Dixon Rd
Suite 250
Kokomo, IN 46902-6409
Phone
(765) 455-2122
Fax
(765) 455-3122
NPI assigned
May 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey Allyn Mossburg, M.S., A.T.C.NPI 1285870147
Title
Athletic Trainer
Phone
(765) 455-2122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

2122 S Dixon Rd
Suite 250
Kokomo, IN 46902-6409

Mailing address

2122 S Dixon Rd
Suite 250
Kokomo, IN 46902-6409
Phone (765) 455-2122

National Provider Directory

National Provider Directory
Tax ID family
North Central Rehabilitation Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2122 S Dixon Rd
Ste 250
Kokomo, IN 46902
Phone (765) 455-2122

Practitioners & affiliated clinicians

Practitioners 1

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": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043267289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 S DIXON RD",
            "address_2": "SUITE 250",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026409",
            "telephone_number": "765-455-2122",
            "fax_number": "765-455-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 S DIXON RD",
            "address_2": "SUITE 250",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026409",
            "telephone_number": "765-455-2122",
            "fax_number": "765-455-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REPLAY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSSBURG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALLYN",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "765-455-2122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., A.T.C."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.