3 Phase Performance Therapy and Sports

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

3 PHASE PERFORMANCE THERAPY AND SPORTS

Practice address

11154 Road 230
Cecil, OH 45821-9309

Phone

(419) 438-5026

Fax

(419) 438-5026

NPI assigned

Jun 11, 2025

Organization subpart

No

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

Authorized official

Name

Seth M Bidlack, OTNPI 1780215657

Title

Owner

Phone

(419) 438-5024

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

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

• Seth Bidlack, OT

  • Physical Rehabilitation Occupational Therapist
  • Cecil, OH
  • NPI 1780215657

  Occupational Therapist, OH

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1619862463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11154 ROAD 230",
            "city": "CECIL",
            "state": "OH",
            "postal_code": "458219309",
            "telephone_number": "419-438-5026",
            "fax_number": "419-438-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11154 ROAD 230",
            "city": "CECIL",
            "state": "OH",
            "postal_code": "458219309",
            "telephone_number": "419-438-5026",
            "fax_number": "419-438-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3 PHASE PERFORMANCE THERAPY AND SPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "BIDLACK",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-438-5024",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 3 Phase Endurance Training LLC
• Stacy A Betzer
• Seth Bidlack, OT
• Jaclyn Carr
• Jama Cline, RN
• Kandise Violet Fisher

• All providers in Cecil, OH
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.