Organization Active NPI

Keystone Rehabilitation Systems Inc

  • Physical Therapy Clinic/Center
  • Willoughby Hills, OH
National Provider Identifier
1396780680
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KEYSTONE REHABILITATION SYSTEMS INC
Practice address
35010 Chardon Rd
Suite 100
Willoughby Hills, OH 44094-9011
Phone
(440) 951-1910
Fax
(440) 951-1940
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Authorized official

Name
Mrs. Jayne Fleck Pool
Title
Chief Compliance Officer
Phone
(469) 467-8705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

35010 Chardon Rd
Suite 100
Willoughby Hills, OH 44094-9011

Mailing address

PO Box 1245
Indiana, PA 15701-5245
Phone (724) 465-3496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000612 OH Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7012826753 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mayfield Village, OH; Orwell, OH; Youngstown, OH

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1396780680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157015245",
            "telephone_number": "724-465-3496",
            "fax_number": "215-413-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35010 CHARDON RD",
            "address_2": "SUITE 100",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949011",
            "telephone_number": "440-951-1910",
            "fax_number": "440-951-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE REHABILITATION SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "FLECK",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-467-8705",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.