NPIMap

Organization Active NPI

Niagara Therapy, LLC

  • Physical Therapy Clinic/Center
  • Erie, PA
National Provider Identifier
1427580836
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT001131E Issued in PA
Legal business name
NIAGARA THERAPY, LLC
Practice address
2631 W 8TH St
Erie, PA 16505-4034
Phone
(814) 464-0627
Fax
(814) 464-0629
NPI assigned
Apr 3, 2017
Last updated
Apr 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Authorized official

Name
Michelle Mioduszewski, MS, OTR/LNPI 1689826075
Title
Owner
Phone
(814) 464-0627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT001131E PA Primary

Addresses

Primary practice location

2631 W 8TH St
Erie, PA 16505-4034

Mailing address

2631 W 8TH St
Erie, PA 16505-4034
Phone (814) 464-0627

National Provider Directory

National Provider Directory
Tax ID family
Niagara Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1427580836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 W 8TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054034",
            "telephone_number": "814-464-0627",
            "fax_number": "814-464-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 W 8TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054034",
            "telephone_number": "814-464-0627",
            "fax_number": "814-464-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIAGARA THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "MIODUSZEWSKI",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-464-0627",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT001131E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.