Physical Medicine Center of Van Wert, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

35-078836 Issued in OH

Legal business name

PHYSICAL MEDICINE CENTER OF VAN WERT, INC.

Practice address

140 Fox Rd
Suite 303
Van Wert, OH 45891-2496

Phone

(419) 232-6333

Fax

(419) 232-6444

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Jocelyn Wray, M.D.

Title

President/Owner

Phone

(419) 232-6333

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1063494250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 FOX RD",
            "address_2": "SUITE 303",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912496",
            "telephone_number": "419-232-6333",
            "fax_number": "419-232-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 FOX RD",
            "address_2": "SUITE 303",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912496",
            "telephone_number": "419-232-6333",
            "fax_number": "419-232-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE CENTER OF VAN WERT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "WRAY",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "419-232-6333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35-078836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2879354",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DO8314",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul A Palmeter
• Amber Nichole Peters, LPN
• Nicholas John Pfleghaar, D.O.
• Yvonne Kay Phillips, EMT, CDCA
• Phoenix Emergency Physicians of the Midwest LLC
• Cailey Pierce
• Katherine Jean Plumley
• Emma Pohlman
• Debbie A Pollock, M.A.
• Kristen N Pollock, D.O.

• Physical Medicine & Rehabilitation Physician in Van Wert, OH
• Providers in Van Wert, OH by specialty
• Physical Medicine & Rehabilitation Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.