NPIMap

Organization Active NPI

Licking Rehabilitation Services Inc

  • Physical Therapist
  • Heath, OH
National Provider Identifier
1467549857
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LICKING REHABILITATION SERVICES INC
Practice address
1220 Hebron Rd
Heath, OH 43056-1040
Phone
(740) 345-2837
Fax
(740) 763-0475
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Authorized official

Name
Jeff C Konkler
Title
Vice President
Phone
(740) 760-0408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

1220 Hebron Rd
Heath, OH 43056-1040

Mailing address

1220 Hebron Rd
Heath, OH 43056-1040
Phone (740) 345-2837

Other practice location 1

159 West Main Street
Newark, OH 43055-5007
Phone (740) 763-0408

Other identifiers 1

IdentifierTypeStateIssuer
2469510MedicaidOH

Other names 1

  • Rehab Associates - Newark Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000004 OH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9638073406 Receives reassigned benefits from 16 practitioners
Practice locations: Gahanna, OH; Zanesville, OH; Worthington, OH; Heath, OH; Dresden, OH; Columbus, OH

National Provider Directory

National Provider Directory
Tax ID family
Licking Rehabilitation Services Inc2 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.

Locations

777 W State St
Ste 302
Columbus, OH 43222
Phone (614) 221-2299

745 W State St
#550A
Columbus, OH 43222

105 W Dave Longaberger Ave
Dresden, OH 43821

608 Main St
Dresden, OH 43821

1220 Hebron Rd
Heath, OH 43056
Phone (740) 763-0408

11171 Lambs Ln
Newark, OH 43055

310 Sunrise Center Dr
Zanesville, OH 43701
Phone (740) 487-4739

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1467549857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HEBRON RD",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430561040",
            "telephone_number": "740-345-2837",
            "fax_number": "740-763-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HEBRON RD",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430561040",
            "telephone_number": "740-345-2837",
            "fax_number": "740-763-0475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 West Main Street",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430555007",
            "country_code": "US",
            "telephone_number": "740-763-0408",
            "fax_number": "740-763-0475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LICKING REHABILITATION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "KONKLER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "740-760-0408"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2469510",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab Associates - Newark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heath, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.