NPIMap

Organization Active NPI

180 Physical Therapy, Inc.

Doing business as 180 Physical Therapy

  • Physical Therapy Clinic/Center
  • Erie, PA
National Provider Identifier
1245476118
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT018397 Issued in PA
Legal business name
180 PHYSICAL THERAPY, INC.
Doing business as
180 Physical Therapy
Practice address
3740 Sterrettania Rd
Erie, PA 16506
Phone
(814) 838-9180
Fax
(814) 838-6180
NPI assigned
Dec 26, 2008
Last updated
Jun 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Authorized official

Name
Mr. John Deangelo, MPT, ATCNPI 1093898363
Title
President
Phone
(814) 504-2973

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT018397 PA Primary

Addresses

Primary practice location

3740 Sterrettania Rd
Erie, PA 16506

Mailing address

3740 Sterrettania Rd
Erie, PA 16506-2829
Phone (814) 838-9180

Other names 1

  • 180 Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090512000472 PA Part B Supplier - Clinic/Group Practice 2062561574 Receives reassigned benefits from 2 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

3740 Sterrettania Rd
Erie, PA 16506
Phone (814) 838-9180

Practitioners & affiliated clinicians

Practitioners 6

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": "1230249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1245476118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 STERRETTANIA RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062829",
            "telephone_number": "814-838-9180",
            "fax_number": "814-838-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 STERRETTANIA RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16506",
            "telephone_number": "814-838-9180",
            "fax_number": "814-838-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "180 PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-26",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "DEANGELO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-504-2973",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT018397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "180 Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "180 Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.