Active NPI
Johnny Michael Repko IV, P.T.
- Physical Therapist
- Springfield, OH
National Provider Identifier
1639301435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 010991
- Practice address
- 2317 E Home Rd
Springfield, OH 45503-2520 - Phone
- (937) 629-3308
- Fax
- (937) 629-3312
- NPI assigned
- Aug 13, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 010991 | OH | Primary |
Addresses
Primary practice location
2317 E Home Rd
Springfield, OH 45503-2520
Mailing address
605 1/2 W Wayne St
Celina, OH 45822-1460
Phone (419) 584-0813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010991 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250121600000",
"number": "1639301435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 1/2 W WAYNE ST",
"city": "CELINA",
"state": "OH",
"postal_code": "458221460",
"telephone_number": "419-584-0813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2317 E HOME RD",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455032520",
"telephone_number": "937-629-3308",
"fax_number": "937-629-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPKO",
"first_name": "JOHNNY",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-13",
"last_updated": "2009-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "010991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.