NPIMap

Organization Active NPI

Rehabilitative Associates Inc

Doing business as Mohican Sport Medicine and Rehab

  • Physical Therapist
  • Bucyrus, OH
National Provider Identifier
1104909217
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REHABILITATIVE ASSOCIATES INC
Doing business as
Mohican Sport Medicine and Rehab
Practice address
351 S Lane St
Suite 1
Bucyrus, OH 44820-2319
Phone
(419) 562-6686
Fax
(419) 562-6625
NPI assigned
Oct 23, 2006
Last updated
Sep 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

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

Authorized official

Name
Robert Tiell
Title
Partner
Phone
(740) 392-8811

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

351 S Lane St
Suite 1
Bucyrus, OH 44820-2319

Mailing address

112 Harcourt Rd
Suite 1
Mount Vernon, OH 43050-3946
Phone (740) 392-8811

Other names 1

  • Mohican Sport Medicine and Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000058 OH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4880598663 Receives reassigned benefits from 11 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bucyrus, OH; Mount Vernon, OH; Mansfield, OH

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mohican Sport Medicine and Rehab3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

351 S Lane St
Ste 1
Bucyrus, OH 44820
Phone (419) 562-6686

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252627200000",
    "number": "1104909217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HARCOURT RD",
            "address_2": "SUITE 1",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503946",
            "telephone_number": "740-392-8811",
            "fax_number": "740-392-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 S LANE ST",
            "address_2": "SUITE 1",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202319",
            "telephone_number": "419-562-6686",
            "fax_number": "419-562-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATIVE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-09-11",
        "status": "A",
        "authorized_official_last_name": "TIELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "740-392-8811"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mohican Sport Medicine and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.