Active NPI
NBJ Outpatient Therapy LLC D/B/a Blue Sky Outpatient Therapy
- Physical Therapist
- Youngstown, OH
National Provider Identifier
1396975678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- NBJ OUTPATIENT THERAPY LLC D/B/A BLUE SKY OUTPATIENT THERAPY
- Practice address
- 1013 Boardman Canfield Rd
Youngstown, OH 44512-4226 - Phone
- (330) 758-4334
- Fax
- (330) 758-4414
- NPI assigned
- Jul 21, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Renee Halfhill, PT
- Title
- President/Owner
- Phone
- (330) 702-0110
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
1013 Boardman Canfield Rd
Youngstown, OH 44512-4226
Mailing address
510 W Main St Ste B
Canfield, OH 44406-1454
Phone (330) 702-0110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2976383 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090928000522 | OH | Part B Supplier - Clinic/Group Practice | 9537248554 |
Receives reassigned benefits from 5 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Beachwood, OH; Canfield, OH; Warren, OH; Akron, OH |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1517184000000",
"number": "1396975678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 W MAIN ST STE B",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444061454",
"telephone_number": "330-702-0110",
"fax_number": "330-702-0510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 BOARDMAN CANFIELD RD",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445124226",
"telephone_number": "330-758-4334",
"fax_number": "330-758-4414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NBJ OUTPATIENT THERAPY LLC D/B/A BLUE SKY OUTPATIENT THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2009-07-21",
"last_updated": "2018-01-29",
"status": "A",
"authorized_official_last_name": "HALFHILL",
"authorized_official_first_name": "RENEE",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "330-702-0110",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2976383",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.