NPIMap

Organization Active NPI

Greenbrier Valley Physical Therapy, LLC

  • Specialist
  • Ronceverte, WV
National Provider Identifier
1407946932
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GREENBRIER VALLEY PHYSICAL THERAPY, LLC
Practice address
3942 Davis Stuart Rd Ste 3
Ronceverte, WV 24970-0269
Phone
(304) 647-3987
Fax
(304) 647-3990
NPI assigned
Oct 13, 2006
Last updated
Nov 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2023

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

Authorized official

Name
Amanda Streeter
Title
Vice President
Phone
(800) 699-9395

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Specialist 174400000X Primary

Addresses

Primary practice location

3942 Davis Stuart Rd Ste 3
Ronceverte, WV 24970-0269

Mailing address

PO Box 932184
Atlanta, GA 31193-4912

Other practice location 1

2901 Salem Low Moor Rd
Low Moor, VA 24457-2445
Phone (540) 862-0068

Other identifiers 2

IdentifierTypeStateIssuer
3810004589MedicaidWV
=========OtherWVWV WORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031209001137 WV Part B Supplier - Clinic/Group Practice 3870499957 Receives reassigned benefits from 62 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Victor, WV; Union, WV; St Albans, WV; Ronceverte, WV; Rainelle, WV; Princeton, WV; Pineville, WV; Peterstown, WV…
O20101103000743 VA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3870499957 Receives reassigned benefits from 17 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Daleville, VA; Hot Springs, VA; Low Moor, VA; Staunton, VA; Waynesboro, VA

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

Locations

29 Cedar Plateau Way
Daleville, VA 24083
Phone (540) 591-6060

5791 Athens Rd
Athens, WV 24712
Phone (304) 301-2500

497 Mall Rd
Unit B
Oak Hill, WV 25901

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700265600000",
    "number": "1407946932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311934912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3942 DAVIS STUART RD STE 3",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249700269",
            "telephone_number": "304-647-3987",
            "fax_number": "304-647-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Salem Low Moor Rd",
            "address_purpose": "LOCATION",
            "city": "Low Moor",
            "state": "VA",
            "postal_code": "244572445",
            "country_code": "US",
            "telephone_number": "540-862-0068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREENBRIER VALLEY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "800-699-9395"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004589",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP",
            "identifier": "=========",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2023; 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.