Rebound Physical Therapy & Sports Performance LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

PT002703 Issued in WV

Legal business name

REBOUND PHYSICAL THERAPY & SPORTS PERFORMANCE LLC

Practice address

560 Main Street
Chapmanville, WV 25508

Phone

(304) 310-4721

Fax

(304) 310-4723

NPI assigned

Mar 29, 2012

Organization subpart

No

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

Authorized official

Name

Derek Dalton, PT, DPTNPI 1437429198

Title

Owner

Phone

(304) 310-4721

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Practitioners 2

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

• Derek Dalton, DPT

  • Physical Therapist
  • Chapmanville, WV
  • NPI 1437429198
  Medicare reassignment Care Compare group NPD Authorized official
• Jill Leann Hensley, PT

  • Physical Therapist
  • Chapmanville, WV
  • NPI 1770255523
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1659647014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 945",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "255080945",
            "telephone_number": "304-310-4721",
            "fax_number": "304-310-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 MAIN STREET",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "25508",
            "telephone_number": "304-310-4721",
            "fax_number": "304-310-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOUND PHYSICAL THERAPY & SPORTS PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-310-4721",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WV",
            "license": "PT002703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2697553",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023132",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Porter
• Rebecca Lynn Price
• Miranda Purkey
• Daniel Quisenberry
• Taylor Rajkovic
• James Darnell Rice
• Terry A Riggins, R.PH
• Hannah Roberts
• Ashley Rose Robertson
• Allyson Robinson

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Chapmanville, WV
• Providers in Chapmanville, WV by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.