NPIMap

Organization Active NPI

Vantage Physical Therapy & Rehabilitation, Inc.

  • Rehabilitation Clinic/Center
  • Johnstown, PA
National Provider Identifier
1487693313
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
VANTAGE PHYSICAL THERAPY & REHABILITATION, INC.
Practice address
336 Bloomfield St
Johnstown, PA 15904-3271
Phone
(814) 269-2224
NPI assigned
Jun 6, 2006
Last updated
Jun 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Authorized official

Name
Ms. Joan Ronan
Title
Treasurer
Phone
(814) 269-2224

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary
Physical Therapist 225100000X
Occupational Therapist 225X00000X

Addresses

Primary practice location

336 Bloomfield St
Johnstown, PA 15904-3271

Mailing address

336 Bloomfield St
Johnstown, PA 15904-3271

Other identifiers 1

IdentifierTypeStateIssuer
1014103920001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030724000007 PA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3072424886 Practice locations: Patton, PA; Sidman, PA; Seward, PA; Nanty Glo, PA; Johnstown, PA; Ebensburg, PA; Central City, PA; Boswell, PA
O20150506001145 PA Part B Supplier - Clinic/Group Practice 3072424886 Receives reassigned benefits from 2 practitioners
Practice locations: Johnstown, PA; Sidman, PA; Seward, PA; Patton, PA; Nanty Glo, PA; Ebensburg, PA; Central City, PA; Boswell, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487693313. Details of each certification follow.

  • CCN 396658 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 396658

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VANTAGE PHYSICAL THERAPY & REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Aug 26, 1993
Last certification
Oct 10, 2024
Ownership / control type
Proprietary
Facility address
336 Bloomfield Street
Johnstown, PA 15904

National Provider Directory

National Provider Directory

Locations

212 Ohio St
#B
Boswell, PA 15531
Phone (814) 629-7299

88 Sunshine Ave
Ste 101
Central City, PA 15926
Phone (814) 754-4422

290 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 472-4921

1761 Goucher St
Ste 104
Johnstown, PA 15905
Phone (814) 255-3566

311 Warren St
Ste 200
Johnstown, PA 15905
Phone (814) 288-3617

3840 William Penn Ave
Ste 10
Nanty Glo, PA 15943
Phone (814) 749-6385

Practitioners & affiliated clinicians

Practitioners 280

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 280

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1487693313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 BLOOMFIELD ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 BLOOMFIELD ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043271",
            "telephone_number": "814-269-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE PHYSICAL THERAPY & REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "RONAN",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "814-269-2224",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014103920001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.