NPIMap

Organization Active NPI

Greenbrier Valley Physical Therapy, LLC

Doing business as Gassaway Physical Therapy

  • Physical Therapist
  • Gassaway, WV
National Provider Identifier
1609311265
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1044-8093 Issued in WV
Legal business name
GREENBRIER VALLEY PHYSICAL THERAPY, LLC
Doing business as
Gassaway Physical Therapy
Practice address
155 Reston PL
Gassaway, WV 26624-9356
Phone
(304) 364-9191
Fax
(304) 364-9193
NPI assigned
Jan 5, 2017
Last updated
Nov 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2023

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

Authorized official

Name
Amanda Streeter
Title
Vice President
Phone
(006) 999-3958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1044-8093 WV Primary

Addresses

Primary practice location

155 Reston PL
Gassaway, WV 26624-9356

Mailing address

484 Riverside Ave
Jacksonville, FL 32202-4912
Phone (800) 699-9395

Other names 1

  • Gassaway Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209001137 WV Part B Supplier - Clinic/Group Practice 3870499957 Receives reassigned benefits from 62 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Victor, WV; Union, WV; St Albans, WV; Ronceverte, WV; Rainelle, WV; Princeton, WV; Pineville, WV; Peterstown, WV…

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

National Provider Directory

National Provider Directory
Tax ID family
Greenbrier Valley Phys26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 7

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": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700265600000",
    "number": "1609311265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024912",
            "telephone_number": "800-699-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 RESTON PL",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266249356",
            "telephone_number": "304-364-9191",
            "fax_number": "304-364-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIER VALLEY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "006-999-3958"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "1044-8093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gassaway Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gassaway Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gassaway, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2023; 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.