Rehab Unlimited at Southbridge, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

36-6707 Issued in OH

Legal business name

REHAB UNLIMITED AT SOUTHBRIDGE, LLC

Practice address

725 Boardman Canfield Rd
Suite a-1
Boardman, OH 44512-4380

Phone

(330) 726-0151

Fax

(330) 726-6540

NPI assigned

Dec 20, 2005

Last updated

Oct 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas P. Yankush, D.C.NPI 1548264484

Title

Owner

Phone

(330) 726-0151

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114903234. Details of each certification follow.

• CCN 366707 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 366707

Legal name

REHAB UNLIMITED AT SOUTHBRIDGE

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Nov 9, 2000

Last certification

Jul 24, 2019

Ownership / control type

Proprietary

Facility address

725 Boardman-Canfield Rd, BLDG a
Boardman, OH 44512

Locations

Practitioners 3

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.

• Thomas P. Yankush, D.C.

  • Chiropractor
  • Boardman, OH
  • NPI 1548264484
  NPD (past) Authorized official
• Michelle Templeton, PT

  • Physical Therapist
  • Youngstown, OH
  • NPI 1811461478
  NPD (past)
• Carla I Theil, PT

  • Physical Therapist
  • Boardman, OH
  • NPI 1942427166
  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1114903234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "address_2": "SUITE A-1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-726-0151",
            "fax_number": "330-726-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "address_2": "SUITE A-1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-726-0151",
            "fax_number": "330-726-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB UNLIMITED AT SOUTHBRIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "YANKUSH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-726-0151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OH",
            "license": "36-6707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2240560",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Cynthia Reardon, DO
• James Joseph Rectenwald
• Rebecca Redick
• Dana Lynn Carly Reeher
• Reema Taneja, M.D., Inc.
• Joseph Reid Jr.
• Ashley Nicole Reimer, MD
• Matthew Theodore Reiter, MAED
• Lauren Rench
• Rexhill LLC (Rexhill Recovery)

• Physical Therapy Clinic/Center in Boardman, OH
• Providers in Boardman, OH by specialty
• Physical Therapy Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.