NPIMap

Organization Active NPI

Bryn Mawr Sports Medicine and Rehabilitation

Doing business as Bryn Mawr Sports Rehab. Inc

  • Physical Therapist
  • Bryn Mawr, PA
National Provider Identifier
1396761904
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT003474L Issued in PA
Legal business name
BRYN MAWR SPORTS MEDICINE AND REHABILITATION
Doing business as
Bryn Mawr Sports Rehab. Inc
Practice address
945 E Haverford Rd
1St Floor
Bryn Mawr, PA 19010-3814
Phone
(610) 525-1223
Fax
(610) 525-5797
NPI assigned
Jul 15, 2006
Last updated
Feb 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Authorized official

Name
Mr. William M Deuber Jr., P.T.NPI 1639101769
Title
President
Phone
(610) 525-1223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003474L PA Primary

Addresses

Primary practice location

945 E Haverford Rd
1St Floor
Bryn Mawr, PA 19010-3814

Mailing address

945 E Haverford Rd
1St Floor
Bryn Mawr, PA 19010-3814
Phone (610) 525-1223

Other names 1

  • Bryn Mawr Sports Rehab. Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000376 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6002804317 Receives reassigned benefits from 9 practitioners
Practice locations: Bryn Mawr, PA

National Provider Directory

National Provider Directory

Locations

945 E Haverford Rd
Fl 1
Bryn Mawr, PA 19010
Phone (610) 525-1223

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1396761904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 E HAVERFORD RD",
            "address_2": "1ST FLOOR",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103814",
            "telephone_number": "610-525-1223",
            "fax_number": "610-525-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 E HAVERFORD RD",
            "address_2": "1ST FLOOR",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103814",
            "telephone_number": "610-525-1223",
            "fax_number": "610-525-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYN MAWR SPORTS MEDICINE AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "DEUBER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-525-1223",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT003474L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryn Mawr Sports Rehab. Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.