Physical Therapy & Sports Rehab, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL THERAPY & SPORTS REHAB, INC.

Practice address

8133 E Market St Ste 1
Warren, OH 44484-2256

Phone

(330) 609-8600

Fax

(330) 609-5237

NPI assigned

Jun 11, 2006

Last updated

Sep 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Alice M. Riffle

Title

Office Manager

Phone

(330) 609-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619919248. Details of each certification follow.

• CCN 366655 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 366655

Legal name

PHYSICAL THERAPY & SPORTS REHAB INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Aug 23, 1996

Last certification

Sep 25, 2014

Ownership / control type

Proprietary

Facility address

8133 East Market Street, Suite 1
Warren, OH 44484

Locations

Practitioners 3

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.

• John J Suhar, PTA

  • Physical Therapy Assistant
  • Warren, OH
  • NPI 1972194736
  NPD
• Sharon J. Alden I, PT

  • Physical Therapist
  • Warren, OH
  • NPI 1316071939
  NPD (past)
• Melissa S. Scheetz, PT

  • Physical Therapist
  • Warren, OH
  • NPI 1649499922
  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1619919248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8133 E MARKET ST STE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842256",
            "telephone_number": "330-609-8600",
            "fax_number": "330-609-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8133 E MARKET ST STE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842256",
            "telephone_number": "330-609-8600",
            "fax_number": "330-609-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY & SPORTS REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "RIFFLE",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-609-8600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0260668",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillips Healthcare LLC (Nightingale Care)
• Ajjiaree Nekeyia Phillips, NP
• Charles Phillips
• Cherin Phillips
• Heather Ann Phillips, CDCA
• Physician's Medical Center Inc
• Physicians Diagnostic & Rehabilitation Center of Warren in
• Angela Jean Pickens
• Alexis Pierce, RN
• Kati Pierce

• Physical Therapist in Warren, OH
• Providers in Warren, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.