NPIMap

Organization Active NPI

Mortland Physical Therapy & Sports Medicine

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • MC Murray, PA
National Provider Identifier
1306887278
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
PT006410L Issued in PA
Legal business name
MORTLAND PHYSICAL THERAPY & SPORTS MEDICINE
Practice address
451 Valley Brook Rd
MC Murray, PA 15317-3353
Phone
(724) 942-8990
Fax
(724) 942-4461
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Mark R. Mortland, PTNPI 1205886017
Title
Owner/President
Phone
(724) 942-8990

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
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081S0010X PT006410L PA Primary

Addresses

Primary practice location

451 Valley Brook Rd
MC Murray, PA 15317-3353

Mailing address

451 Valley Brook Rd
MC Murray, PA 15317-3353
Phone (724) 942-8990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040504001009 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890783260 Receives reassigned benefits from 4 practitioners
Practice locations: MC Murray, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1306887278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 VALLEY BROOK RD",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173353",
            "telephone_number": "724-942-8990",
            "fax_number": "724-942-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 VALLEY BROOK RD",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173353",
            "telephone_number": "724-942-8990",
            "fax_number": "724-942-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTLAND PHYSICAL THERAPY & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "MORTLAND",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "724-942-8990",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "PT006410L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Murray, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.