NPIMap

Organization Active NPI

Mountain River Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Parkersburg, WV
National Provider Identifier
1689100828
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MOUNTAIN RIVER PHYSICAL THERAPY, LLC
Practice address
2804 Birch St
Parkersburg, WV 26101-1910
Phone
(304) 865-6778
Fax
(304) 865-7400
NPI assigned
May 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Krista Rogers
Title
Vice President of Operations
Phone
(304) 917-3660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2804 Birch St
Parkersburg, WV 26101-1910

Mailing address

415 36TH St
Suite 100
Parkersburg, WV 26101-1005
Phone (304) 917-3660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000524 WV Part B Supplier - Clinic/Group Practice 0547259335 Receives reassigned benefits from 19 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ripley, WV; Williamstown, WV; Wheeling, WV; Wellsburg, WV; Vienna, WV; Ravenswood, WV; Point Pleasant, WV; Parkersburg, WV…

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1494288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1689100828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST",
            "address_2": "SUITE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 BIRCH ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011910",
            "telephone_number": "304-865-6778",
            "fax_number": "304-865-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIVER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-09",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "304-917-3660"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.