Genesis Physical Therapy & Wellness Center, L.L.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT006483 Issued in OH

Legal business name

GENESIS PHYSICAL THERAPY & WELLNESS CENTER, L.L.C.

Practice address

4230 E. National Road (Rear)
Springfield, OH 45505-1714

Phone

(937) 323-8000

Fax

(937) 323-6960

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Randal S. Richardson, PTNPI 1518038314

Title

Owner

Phone

(937) 323-8000

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Randal S Richardson, P.T.

  • Physical Medicine & Rehabilitation Physician
  • Springfield, OH
  • NPI 1518038314
  NPD (past) Authorized official
• Jacqueline Dahlberg, M.S., R.D., L.D.

  • Registered Dietitian
  • Springfield, OH
  • NPI 1922255165
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1215008990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 E. NATIONAL ROAD (REAR)",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455051714",
            "telephone_number": "937-323-8000",
            "fax_number": "937-323-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 E. NATIONAL ROAD (REAR)",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455051714",
            "telephone_number": "937-323-8000",
            "fax_number": "937-323-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHYSICAL THERAPY & WELLNESS CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-323-8000",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "PT006483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Gaunt
• Renia Nicole Gavin
• Kimberly Gaynor
• Elizabeth Madonna Gearin, MS, RD, LD
• Aaron Gehring
• Charlotte Gengler
• Genoa Healthcare LLC
• Patricia Gentry-Young, HAIR LOSS SPECIALIST
• George Varghese MD & Assoc Inc
• Erin Elizabeth George, MSW, LISW-S

• Physical Medicine & Rehabilitation Physician in Springfield, OH
• Providers in Springfield, OH by specialty
• Physical Medicine & Rehabilitation Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.