NPIMap

Organization Active NPI

Atlantic Sports & Rehab Services, Inc.

  • Occupational Therapist
  • Charlottesville, VA
National Provider Identifier
1245354828
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119004444 Issued in VA
Legal business name
ATLANTIC SPORTS & REHAB SERVICES, INC.
Practice address
1410 Incarnation Drive, Ste 101
Charlottesville, VA 22901
Phone
(434) 978-4915
Fax
(434) 978-7194
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Mr. Mark Tulenko, PT
Title
Director
Phone
(434) 978-4915

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X VA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 0119004444 VA Primary

Addresses

Primary practice location

1410 Incarnation Drive, Ste 101
Charlottesville, VA 22901

Mailing address

1410 Incarnation Drive, Ste 101
Charlottesville, VA 22901
Phone (434) 978-4915

Other identifiers 1

IdentifierTypeStateIssuer
004980328MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 496765

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ATLANTIC SPORTS AND REHAB
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Apr 7, 2023
Last certification
Mar 22, 2023
Ownership / control type
Proprietary
Facility address
1410 Incarnation Drive, Suite 101
Charlottesville, VA 22901

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Sports Rehab Services Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1245354828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 INCARNATION DRIVE, STE 101",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-978-4915",
            "fax_number": "434-978-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 INCARNATION DRIVE, STE 101",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-978-4915",
            "fax_number": "434-978-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC SPORTS & REHAB SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "TULENKO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "434-978-4915",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004980328",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.