Mountain State Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MOUNTAIN STATE PHYSICAL THERAPY LLC

Doing business as

Mountain State Physical Therapy

Practice address

200 Fairmont Ave Ste 104
Fairmont, WV 26554-0171

Phone

(304) 363-8543

Fax

(304) 363-0173

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Andrew J. Barrish, PTNPI 1427004191

Title

President

Phone

(304) 363-8543

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Mountain State Physical Therapy Doing business as
• Dino Rovito Etal Ptr Former legal business name

Locations

Practitioners 7

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.

• Andrew J. Barrish, PT

  • Physical Therapist
  • Fairmont, WV
  • NPI 1427004191
  Authorized official Same address or phone
• Kevin A Passerby, MPT

  • Physical Therapist
  • Kingwood, WV
  • NPI 1275546905
  NPD (past)
• Patricia Ann Shaw, M.D.

  • Psychiatry Physician
  • Clarksburg, WV
  • NPI 1962768770
  NPD (past)
• Jonathan B Wilson, DPT

  • Physical Therapist
  • Mannington, WV
  • NPI 1760791552
  NPD (past)
• Brad Ciccolella, PT, MPT, OCS

  • Physical Therapist
  • Ebensburg, PA
  • NPI 1346328465
  NPD (past)
• Stephen Murphy

  • Physical Therapist
  • Westfield, MA
  • NPI 1215943485
  NPD (past)
• Mason H Rockwell, PT

  • Physical Therapist
  • Anderson, SC
  • NPI 1487677274
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1083668875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FAIRMONT AVE STE 104",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265540171",
            "telephone_number": "304-363-8543",
            "fax_number": "304-363-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FAIRMONT AVE STE 104",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265540171",
            "telephone_number": "304-363-8543",
            "fax_number": "304-363-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "BARRISH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-363-8543",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202606000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB3679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain State Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain State Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dino Rovito Etal Ptr",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gentry Ann Morrone
• De Sean Mosley
• Christine Lynn Mott, CFNP
• Mountain Grace Women's Wellness Center LLC
• Mountain River Physical Therapy, LLC
• Mountaineer Case Management
• Mountaineer Life Enrichment Center, LLC
• Sierra Michelle Mounts
• Erica Nicole Mouser, MOT/L
• Rachel Moye

• Physical Therapy Clinic/Center in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Physical Therapy Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.