Active NPI
SMR Banyan Tree, Inc.
- Rehabilitation Clinic/Center
- Austintown, OH
National Provider Identifier
1497784052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Clinic/Center
- Legal business name
- SMR BANYAN TREE, INC.
- Practice address
- 5401 Ashley Cir
Suite F
Austintown, OH 44515-1176 - Phone
- (330) 792-1223
- Fax
- (330) 792-1814
- NPI assigned
- Jul 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael E Tarvin
- Title
- Vice President & Secretary
- Phone
- (717) 972-1100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Primary |
Addresses
Primary practice location
5401 Ashley Cir
Suite F
Austintown, OH 44515-1176
Mailing address
4714 Gettysburg Rd
Legal Dept
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100
Other names 1
- Novacare Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051109000052 | OH | Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 2961420880 |
10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Warren, OH |
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
5401 Ashley Cir
Ste F
Austintown, OH 44515
Phone (330) 792-1223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1542758400000",
"number": "1497784052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4714 GETTYSBURG RD",
"address_2": "LEGAL DEPT",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170554325",
"telephone_number": "717-972-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 ASHLEY CIR",
"address_2": "SUITE F",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445151176",
"telephone_number": "330-792-1223",
"fax_number": "330-792-1814"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMR BANYAN TREE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-03",
"last_updated": "2018-11-21",
"status": "A",
"authorized_official_last_name": "TARVIN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
"authorized_official_telephone_number": "717-972-1100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Novacare Rehabilitation",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Novacare Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Austintown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.