NPIMap

Organization Active NPI

WV Therapy Services LLC

  • Specialist
  • Bridgeport, WV
National Provider Identifier
1063692333
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0420593001 Issued in WV
Legal business name
WV THERAPY SERVICES LLC
Practice address
306 W Main St
Bridgeport, WV 26330-1751
Phone
(304) 842-9887
Fax
(304) 842-9888
NPI assigned
Nov 5, 2007
Last updated
Mar 25, 2009By the provider in NPPES
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
Mr. Gregory Alan Hayes, PTA
Title
Managing Member
Phone
(304) 842-9887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0420593001 WV Primary

Addresses

Primary practice location

306 W Main St
Bridgeport, WV 26330-1751

Mailing address

415 Benedum Dr
Bridgeport, WV 26330-1503
Phone (304) 842-9887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080428000417 WV Part B Supplier - Clinic/Group Practice 8123106416 Receives reassigned benefits from 41 practitioners
Practice locations: Bridgeport, WV
O20231114001270 VA Part B Supplier - Clinic/Group Practice 8123106416 Receives reassigned benefits from 9 practitioners
Practice locations: Burkeville, VA

National Provider Directory

National Provider Directory
Tax ID family
Odyssey Rehabilitation2 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

415 Benedum Dr
Bridgeport, WV 26330
Phone (304) 842-9887

1 Freedoms Way
Clarksburg, WV 26301
Phone (304) 626-1600

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1063692333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BENEDUM DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301503",
            "telephone_number": "304-842-9887",
            "fax_number": "304-842-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301751",
            "telephone_number": "304-842-9887",
            "fax_number": "304-842-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "304-842-9887",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "0420593001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

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.
  • 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.