Southern West Virginia Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

002118 Issued in WV

Legal business name

SOUTHERN WEST VIRGINIA PHYSICAL THERAPY

Practice address

6107 Crawley Creek Rd.
Chapmanville, WV 25508

Phone

(304) 855-9500

Fax

(304) 855-9525

NPI assigned

Nov 26, 2007

Last updated

Jul 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Patrick M Ellis, MSPTNPI 1114028214

Title

Physical Therapist/ Owner

Phone

(304) 855-9500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Practitioners 3

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.

• Patrick M Ellis, MSPT

  • Physical Therapist
  • Chapmanville, WV
  • NPI 1114028214
  Medicare reassignment Care Compare group NPD Authorized official
• Michael Sean Guilliams, DPT

  • Physical Therapist
  • Danville, WV
  • NPI 1932930294
  Medicare reassignment Care Compare group NPD
• Olivia Bias

  • Physical Therapist
  • Chapmanville, WV
  • NPI 1275364119
  NPD

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1245411701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255081647",
            "telephone_number": "304-855-9500",
            "fax_number": "304-855-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 CRAWLEY CREEK RD.",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "25508",
            "telephone_number": "304-855-9500",
            "fax_number": "304-855-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN WEST VIRGINIA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/ OWNER",
        "authorized_official_telephone_number": "304-855-9500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7302394000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Slazo
• Lora Sloan
• Genieve Smith, NP
• Jacqueline Smith
• Kimberly Dawn Smith
• Yolanda Ann Sowers
• Travis Spradlin, M.ED, LPC
• Magalene Springer
• Timothy Dale Stevens
• Anthony Scott Stollings

• Physical Therapist in Chapmanville, WV
• Providers in Chapmanville, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.