NPIMap

Organization Active NPI

Greenbrier Valley Physical Therapy, LLC

  • Specialist
  • Marlinton, WV
National Provider Identifier
1124118658
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GREENBRIER VALLEY PHYSICAL THERAPY, LLC
Practice address
18228 Seneca Trail
Marlinton, WV 24954
Phone
(304) 799-4500
Fax
(304) 799-4501
NPI assigned
Oct 13, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Amanda Streeter
Title
Vice President
Phone
(800) 699-9395

Other NPIs on the same Medicare enrollment 21

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

View all 21

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209001137 WV Part B Supplier - Clinic/Group Practice 3870499957 Receives reassigned benefits from 62 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Victor, WV; Union, WV; St Albans, WV; Ronceverte, WV; Rainelle, WV; Princeton, WV; Pineville, WV; Peterstown, WV…

National Provider Directory

National Provider Directory
Tax ID family
Greenbrier Valley Physi26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

155 Reston Pl
Gassaway, WV 26624
Phone (304) 228-7620

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

NPPES NPI Registry

Primary practice location

18228 Seneca Trail
Marlinton, WV 24954

Mailing address

484 Riverside Ave
Jacksonville, FL 32202-4912
Phone (800) 699-9395

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
3810004589MedicaidWV
=========OtherWVWV WORKERS COMP

Other names 1

NPPES NPI Registry
  • SENECA TRAIL PHYSICAL THERAPY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 18, 2023.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700265600000",
    "number": "1124118658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024912",
            "telephone_number": "800-699-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18228 SENECA TRAIL",
            "city": "MARLINTON",
            "state": "WV",
            "postal_code": "24954",
            "telephone_number": "304-799-4500",
            "fax_number": "304-799-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIER VALLEY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "800-699-9395"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004589",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP",
            "identifier": "=========",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SENECA TRAIL PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SENECA TRAIL PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlinton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2023; 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.