Physio Balance and Sports Performance, LLC

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

Legal business name

PHYSIO BALANCE AND SPORTS PERFORMANCE, LLC

Practice address

1587 Boettler Rd Ste 140
Uniontown, OH 44685

Phone

(330) 687-6891

Fax

(330) 362-2623

NPI assigned

Aug 23, 2018

Last updated

Jul 16, 2020By 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

Verrelle Lee Wyatt, PT, DPTNPI 1447649173

Title

Physical Therapist

Phone

(330) 942-3316

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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.

• Verrelle Lee Wyatt, PT, DPT

  • Physical Therapist
  • Uniontown, OH
  • NPI 1447649173

  Sports

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1255812715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 BOETTLER RD STE 140",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446857823",
            "telephone_number": "330-687-6891",
            "fax_number": "330-362-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1587 BOETTLER RD STE 140",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "44685",
            "telephone_number": "330-687-6891",
            "fax_number": "330-362-2623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3045 Smith Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443334459",
            "country_code": "US",
            "telephone_number": "330-576-6687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1587 Boettler Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "OH",
            "postal_code": "44685",
            "country_code": "US",
            "telephone_number": "330-687-6891",
            "fax_number": "330-362-2623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSIO BALANCE AND SPORTS PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "VERRELLE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "330-942-3316",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Alane Perez, MA, LPCC
• Ani Peshel
• Katiera Nicole Pfeister, LPC
• Carla Pham, CNP
• Pharmco Management, LLC (Compounding Pharmacy of Green)
• Physio Balance Wellness Centers (Physio TPR)
• Pioneer Physicians Network, Inc.
• Pioneer Physicians Network, Inc.
• Dana Pipino, M.A. CCC-SLP
• Mary A Pletcher

• Sports Physical Therapist in Uniontown, OH
• Providers in Uniontown, OH by specialty
• Sports Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.