NPIMap

Organization Active NPI

Integrated Health Care Providers, Inc

Doing business as Sports Medicine & Rehab Center Cross Lanes

  • Physical Therapist
  • Cross Lanes, WV
National Provider Identifier
1417976382
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
INTEGRATED HEALTH CARE PROVIDERS, INC
Doing business as
Sports Medicine & Rehab Center Cross Lanes
Practice address
130 Goff Mountain Rd
Cross Lanes, WV 25313-1419
Phone
(304) 388-7055
Fax
(304) 388-7058
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Jeffrey H. Goode, PT, MBA
Title
President
Phone
(304) 388-7783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

130 Goff Mountain Rd
Cross Lanes, WV 25313-1419

Mailing address

415 Morris St
Suite 304
Charleston, WV 25301-1842
Phone (304) 388-7782

Other identifiers 1

IdentifierTypeStateIssuer
3810006518MedicaidWV

Other names 1

  • Sports Medicine & Rehab Center Cross Lanes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Integrated Health Care Providers Inc51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1417976382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST",
            "address_2": "SUITE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011842",
            "telephone_number": "304-388-7782",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GOFF MOUNTAIN RD",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131419",
            "telephone_number": "304-388-7055",
            "fax_number": "304-388-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH CARE PROVIDERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-388-7783",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006518",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Medicine & Rehab Center Cross Lanes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cross Lanes, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.