NPIMap

Organization Active NPI

Weaver Physical Therapy, LLC

  • Physical Therapist
  • Latrobe, PA
National Provider Identifier
1154094068
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
WEAVER PHYSICAL THERAPY, LLC
Practice address
3960 Route 30 Ste 104
Latrobe, PA 15650-5518
Phone
(724) 532-3422
Fax
(724) 532-3424
NPI assigned
Jul 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Authorized official

Name
Mr. Brock Andrew Weaver, DPTNPI 1417258856
Title
President/Owner
Phone
(724) 532-3422

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 Primary

Addresses

Primary practice location

3960 Route 30 Ste 104
Latrobe, PA 15650-5518

Mailing address

3960 Route 30 Ste 104
Latrobe, PA 15650-5518
Phone (724) 532-3422

Other practice location 1

111 E Church St Ste B
Ligonier, PA 15658-1257
Phone (724) 238-2099

Other names 1

  • In-Sync Rehabilitation Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210810004063 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022412238 Receives reassigned benefits from 4 practitioners
Practice locations: Latrobe, PA; Ligonier, PA

National Provider Directory

National Provider Directory
Tax ID family
In Sync Rehabilitation Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

111 E Church St
Ste B
Ligonier, PA 15658
Phone (724) 238-2099

Practitioners & affiliated clinicians

Practitioners 5

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": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1154094068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 ROUTE 30 STE 104",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156505518",
            "telephone_number": "724-532-3422",
            "fax_number": "724-532-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 ROUTE 30 STE 104",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156505518",
            "telephone_number": "724-532-3422",
            "fax_number": "724-532-3424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E Church St Ste B",
            "address_purpose": "LOCATION",
            "city": "Ligonier",
            "state": "PA",
            "postal_code": "156581257",
            "country_code": "US",
            "telephone_number": "724-238-2099",
            "fax_number": "724-238-2119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WEAVER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "724-532-3422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In-Sync Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.