NPIMap

Organization Active NPI

Als Mount Vernon Inc

  • Physical Therapy Clinic/Center
  • Mount Vernon, OH
National Provider Identifier
1053987446
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ALS MOUNT VERNON INC
Practice address
1135 Gambier Rd
Mount Vernon, OH 43050-3839
Phone
(740) 415-1138
NPI assigned
May 27, 2021
Last updated
Jul 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Jeff Degyansky
Title
VP of Operations
Phone
(330) 620-7828

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU
Physical Therapy Clinic/Center 261QP2000X NU Primary
Occupational Medicine Clinic/Center 261QX0100X NU

Addresses

Primary practice location

1135 Gambier Rd
Mount Vernon, OH 43050-3839

Mailing address

26261 Main St
Coolville, OH 45723-9204
Phone (740) 350-9095

Other identifiers 2

IdentifierTypeStateIssuer
2630NOtherOHLICENSURE
0234954MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Als Mount Vernon LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1053987446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26261 MAIN ST",
            "city": "COOLVILLE",
            "state": "OH",
            "postal_code": "457239204",
            "telephone_number": "740-350-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 GAMBIER RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503839",
            "telephone_number": "740-415-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALS MOUNT VERNON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "DEGYANSKY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "330-620-7828"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "2630N",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0234954",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.