NPIMap

Organization Active NPI

Pottsville Sports & Rehabilitation Center, Inc.

  • Physical Therapist
  • Pottsville, PA
National Provider Identifier
1174694012
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016753 Issued in PA
Legal business name
POTTSVILLE SPORTS & REHABILITATION CENTER, INC.
Practice address
2040 W End Ave
Pottsville, PA 17901-1922
Phone
(570) 622-9198
Fax
(570) 622-6011
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John Tice Dolbin
Title
Partner
Phone
(570) 622-9198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT016753 PA Primary

Addresses

Primary practice location

2040 W End Ave
Pottsville, PA 17901-1922

Mailing address

2040 W End Ave
Pottsville, PA 17901-1922
Phone (570) 622-9198

National Provider Directory

National Provider Directory

Locations

2040 W End Ave
Pottsville, PA 17901
Phone (570) 622-7291

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174694012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W END AVE",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179011922",
            "telephone_number": "570-622-9198",
            "fax_number": "570-622-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W END AVE",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179011922",
            "telephone_number": "570-622-9198",
            "fax_number": "570-622-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSVILLE SPORTS & REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOLBIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TICE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-622-9198"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.