NPIMap

Organization Active NPI

Drayer Physical Therapy Institute LLC

  • Physical Therapist
  • Altoona, PA
National Provider Identifier
1629612650
Registry record updated Nov 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY INSTITUTE LLC
Practice address
2900 Plank Rd Ste 2
Altoona, PA 16601-9361
Phone
(423) 541-5490
NPI assigned
Nov 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2019

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

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-8923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2900 Plank Rd Ste 2
Altoona, PA 16601-9361

Mailing address

1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000110 PA Part B Supplier - Clinic/Group Practice 8224948666 Receives reassigned benefits from 404 practitioners
48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 48

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

View all 48

National Provider Directory

National Provider Directory

Locations

2900 Plank Rd
Ste 2
Altoona, PA 16601
Phone (423) 541-5490

NPI Registry JSON

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

{
    "created_epoch": "1572652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572652800000",
    "number": "1629612650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 PLANK RD STE 2",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166019361",
            "telephone_number": "423-541-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-02",
        "last_updated": "2019-11-02",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-8923"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2019; 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.