Individual provider Active NPI

Tina Harris, PT

  • Physical Therapist
  • Brecksville, OH
National Provider Identifier
1376625012
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006790 Issued in OH
Practice address
6950 South Edgerton
Brecksville, OH 44141
Phone
(440) 746-1730
Fax
(440) 746-1732
NPI assigned
Oct 20, 2006
Last updated
May 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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 006790 OH Primary

Addresses

Primary practice location

6950 South Edgerton
Brecksville, OH 44141

Mailing address

2132 Case Parkway N Suite a
Twinsburg, OH 44087
Phone (330) 963-2920

Other identifiers 1

IdentifierTypeStateIssuer
311556919OtherOHTAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000294 OH Practitioner - Physical Therapist in Private Practice 4789622200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Physical Therapy, IncGroup PAC ID 5991696544, 13 clinicians

Practice addresses (Care Compare)

6950 S Edgerton Rd
Brecksville, OH 44141-3184
Phone (440) 746-1730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006790OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Physical Therapy, Inc Physical Therapist CurrentSince May 9, 2021 Accepting new patients

Locations

2132 Case Pkwy
Ste A
Twinsburg, OH 44087
Phone (330) 963-2920

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1376625012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 CASE PARKWAY N SUITE A",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "44087",
            "telephone_number": "330-963-2920",
            "fax_number": "330-963-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 SOUTH EDGERTON",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "44141",
            "telephone_number": "440-746-1730",
            "fax_number": "440-746-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TINA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "006790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "311556919",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brecksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.