Greenbrier Valley Physical Therapy, LLC
Organization Active NPI Physical Therapist · Rainelle, WV
NPI 1194154237 · NPPES record last updated Nov 18, 2023
Key facts
- NPI
- 1194154237
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- GREENBRIER VALLEY PHYSICAL THERAPY, LLC
- Practice address
- 390 John Raine Dr
Rainelle, WV 25962-1462 - Phone
- (304) 438-9225
- Fax
- (304) 438-9226
- NPI assigned
- Nov 8, 2013
- Organization subpart
- No
Authorized official
- Name
- Amanda Streeter
- Title
- Vice President
- Phone
- (800) 699-9395
Other NPIs on the same Medicare enrollment 21
Corporate family (same tax ID) 25
Practitioners 5
-
Michael Glenn Fraley, DPT, ATC
-
Travis L McClintic, DPT
-
Andrew Robinson, DPT
-
Kevin A Workman, MPT/ATC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Greenbrier Valley Physi
Locations
390 John Raine Dr
Rainelle, WV 25962
Phone (304) 438-9225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
390 John Raine Dr
Rainelle, WV 25962-1462
Mailing address
PO Box 932184
Atlanta, GA 31193-4912
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9295191 | Other | WV | MEDICARE PTAN |
Other names
- MASTERWORKS PHYSICAL THERAPY
Other providers in Rainelle, WV
- Xavier James Georger
- Lora Gipson
- God'S Way Home, Inc.
- Brenda Goins
- Trista T Graham
- Audra Gregg
- Kenneth Earl Gwinn Jr.
- Donna Rosetta Hamrick
- Abrienda Alexandria Hanna
- Alyssa Ann Hanna
All providers in Rainelle, WV · Physical Therapist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.