Organization Active NPI

Titan Physio & Sports Performance

  • Physical Therapy Clinic/Center
  • Malvern, PA
National Provider Identifier
1104717677
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
TITAN PHYSIO & SPORTS PERFORMANCE
Practice address
17 Ravine Rd
Malvern, PA 19355-1301
Phone
(484) 358-3026
Fax
(877) 755-9534
NPI assigned
Jul 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Vancouier Barrett, DPTNPI 1063030468
Title
Owner/Physical Therapist
Phone
(484) 358-3026

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

17 Ravine Rd
Malvern, PA 19355-1301

Mailing address

2803 Stoneham Dr
West Chester, PA 19382-6648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251218000569 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628563509 Receives reassigned benefits from 1 practitioner
Practice locations: Malvern, PA

National Provider Directory

National Provider Directory

Locations

17 Ravine Rd
Malvern, PA 19355
Phone (484) 358-3026

Practitioners & affiliated clinicians

Practitioners 1

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": "1752451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1104717677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 STONEHAM DR",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193826648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 RAVINE RD",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551301",
            "telephone_number": "484-358-3026",
            "fax_number": "877-755-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN PHYSIO & SPORTS PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-13",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "VANCOUIER",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "484-358-3026",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.