Organization Active NPI

Riverside Physical Therapy LLC

  • Physical Therapist
  • Proctorville, OH
National Provider Identifier
1124116173
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1007 Issued in OH
Legal business name
RIVERSIDE PHYSICAL THERAPY LLC
Practice address
96 Township Road 369
Suite 104
Proctorville, OH 45669-9133
Phone
(740) 886-5555
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Thomas Lambiotte, P.T.NPI 1184705519
Title
Clinic Director
Phone
(740) 886-5555

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT-1007 OH Primary

Addresses

Primary practice location

96 Township Road 369
Suite 104
Proctorville, OH 45669-9133

Mailing address

96 Township Road 369
Suite 104
Proctorville, OH 45669-9133
Phone (740) 886-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060124000001 OH Part B Supplier - Clinic/Group Practice 3173547635 Receives reassigned benefits from 2 practitioners
Practice locations: Proctorville, OH; South Point, OH

National Provider Directory

National Provider Directory

Locations

5839 County Road 107
Proctorville, OH 45669
Phone (740) 886-5555

96 Township Road 369
Ste 104
Proctorville, OH 45669
Phone (740) 886-5555

50 Township Road 1012
#B
South Point, OH 45680
Phone (740) 894-1424

Practitioners & affiliated clinicians

Practitioners 2

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1124116173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 TOWNSHIP ROAD 369",
            "address_2": "SUITE 104",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456699133",
            "telephone_number": "740-886-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 TOWNSHIP ROAD 369",
            "address_2": "SUITE 104",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456699133",
            "telephone_number": "740-886-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "LAMBIOTTE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "740-886-5555",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-1007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Proctorville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.