NPIMap

Organization Active NPI

Neuroaxis Rehabilitation Services

  • Physical Therapy Clinic/Center
  • Canonsburg, PA
National Provider Identifier
1063172807
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEUROAXIS REHABILITATION SERVICES
Practice address
1159 Bayberry Dr
Canonsburg, PA 15317-4992
Phone
(724) 705-4311
NPI assigned
Dec 21, 2021
Last updated
Feb 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Authorized official

Name
Kelsey Harris, PT, DPT, RPSFCNPI 1659901858
Title
Owner/ Physical Therapist
Phone
(724) 705-4311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1159 Bayberry Dr
Canonsburg, PA 15317-4992

Mailing address

1159 Bayberry Dr
Canonsburg, PA 15317-4992
Phone (724) 705-4311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220209000594 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7012300387 Receives reassigned benefits from 22 practitioners
Practice locations: Canonsburg, PA; Pittsburgh, PA; Washington, PA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

135 Technology Dr
Ste 100
Canonsburg, PA 15317
Phone (724) 585-8145

3735 Saxonburg Blvd
Pittsburgh, PA 15238
Phone (412) 213-8667

5500 Butler St
Pittsburgh, PA 15201
Phone (724) 585-8145

5500 Butler St
Unit B
Pittsburgh, PA 15201
Phone (724) 585-8145

383 Dixon Blvd
Uniontown, PA 15401
Phone (724) 366-1166

125 Granville Sq
Ste 113
Morgantown, WV 26501
Phone (724) 585-8145

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1063172807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 BAYBERRY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153174992",
            "telephone_number": "724-705-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 BAYBERRY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153174992",
            "telephone_number": "724-705-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROAXIS REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER/ PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "724-705-4311",
        "authorized_official_credential": "PT, DPT, RPSFC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.