Organization Active NPI

Restore Physical Therapy Plus Wellness LLC

  • Physical Therapy Clinic/Center
  • Russia, OH
National Provider Identifier
1578144572
Registry record updated Sep 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RESTORE PHYSICAL THERAPY PLUS WELLNESS LLC
Practice address
229 W Main St
Russia, OH 45363-9631
Phone
(937) 418-9897
NPI assigned
Apr 20, 2021
Last updated
Sep 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2024

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

Authorized official

Name
Katie BargaNPI 1982299780
Title
Physical Therapist
Phone
(937) 418-9897

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 Primary

Addresses

Primary practice location

229 W Main St
Russia, OH 45363-9631

Mailing address

229 W Main St
Russia, OH 45363-9631

Other names 1

  • Katie M. Barga LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210507001273 OH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0547679367 Receives reassigned benefits from 2 practitioners
Practice locations: Russia, OH

National Provider Directory

National Provider Directory

Locations

102 E Main St
Russia, OH 45363
Phone (937) 418-9897

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727568000000",
    "number": "1578144572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W MAIN ST",
            "city": "RUSSIA",
            "state": "OH",
            "postal_code": "453639631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W MAIN ST",
            "city": "RUSSIA",
            "state": "OH",
            "postal_code": "453639631",
            "telephone_number": "937-418-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE PHYSICAL THERAPY PLUS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A",
        "authorized_official_last_name": "BARGA",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "937-418-9897"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katie M. Barga LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Russia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.