Individual provider Active NPI

Justin Perry, PT

  • Physical Therapist
  • Salem, OH
National Provider Identifier
1336214824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
09647 Issued in OH
Practice address
2308 Southeast Blvd
Salem, OH 44460-3418
Phone
(330) 332-8488
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 09647 OH Primary

Addresses

Primary practice location

2308 Southeast Blvd
Salem, OH 44460-3418

Mailing address

926 N Ellsworth Ave
Salem, OH 44460-1534
Phone (330) 337-6457

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130326000625 OH Practitioner - Physical Therapist in Private Practice 0244475002 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09647OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Rehabilitation of Ohio Inc CurrentSince Jun 1, 2018 Accepting new patients
Novacare Rehabilitation of Ohio, Inc. Physical Therapist CurrentSince Jun 1, 2018 Accepting new patients
Novacare Rehabilitation of Ohio Inc Past Accepting new patients

Locations

100 Royal Birkdale Dr
Columbiana, OH 44408
Phone (330) 482-3726

803 E Washington St
Ste 130
Medina, OH 44256
Phone (330) 725-4200

656 Youngstown Warren Rd
Niles, OH 44446
Phone (330) 505-1362

2308 Southeast Blvd
Salem, OH 44460
Phone (330) 332-8488

2614 E Market St
Warren, OH 44483
Phone (330) 394-8181

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336214824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 N ELLSWORTH AVE",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444601534",
            "telephone_number": "330-337-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 SOUTHEAST BLVD",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444603418",
            "telephone_number": "330-332-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JUSTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "09647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.