NPIMap

Organization Active NPI

Physical Therapy and Rehabilitation Clinic Inc

  • Physical Therapist
  • Atlasburg, PA
National Provider Identifier
1063588093
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001148E Issued in PA
Legal business name
PHYSICAL THERAPY AND REHABILITATION CLINIC INC
Practice address
1569 Smith Township State Road
Suite 2
Atlasburg, PA 15004
Phone
(724) 947-9999
Fax
(740) 264-4376
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Authorized official

Name
Dave J Rasicci, DPT
Title
Owner
Phone
(724) 947-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT001148E PA Primary

Addresses

Primary practice location

1569 Smith Township State Road
Suite 2
Atlasburg, PA 15004

Mailing address

1569 Smith Township State Road
Suite 2
Atlasburg, PA 15004
Phone (724) 947-9999

Other identifiers 2

IdentifierTypeStateIssuer
0019673260001MedicaidPA
485432OtherPABLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1063588093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 SMITH TOWNSHIP STATE ROAD",
            "address_2": "SUITE 2",
            "city": "ATLASBURG",
            "state": "PA",
            "postal_code": "15004",
            "telephone_number": "724-947-9999",
            "fax_number": "740-264-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 SMITH TOWNSHIP STATE ROAD",
            "address_2": "SUITE 2",
            "city": "ATLASBURG",
            "state": "PA",
            "postal_code": "15004",
            "telephone_number": "724-947-9999",
            "fax_number": "740-264-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND REHABILITATION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "RASICCI",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-947-9999",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT001148E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019673260001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "485432",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlasburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.