NPIMap

Organization Active NPI

SMR Banyan Tree, Inc.

Doing business as NovaCare Rehabilitation

  • Physical Therapist
  • Warren, OH
National Provider Identifier
1689604084
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SMR BANYAN TREE, INC.
Doing business as
NovaCare Rehabilitation
Practice address
140 Highland Terrace Blvd
Suite B
Warren, OH 44484-3074
Phone
(330) 652-8733
Fax
(330) 652-0030
NPI assigned
Jul 3, 2006
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
John F Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

140 Highland Terrace Blvd
Suite B
Warren, OH 44484-3074

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • NovaCare Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000052 OH Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2961420880 10 other NPIs on this enrollment
Practice locations: Warren, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689604084. Details of each certification follow.

  • CCN 366609 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 366609

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NOVACARE REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Oct 14, 1992
Last certification
Jun 10, 2015
Ownership / control type
Proprietary
Facility address
140 Highland Terrace Blvd Suite B
Warren, OH 44484

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

5257 Nike Rd
Hilliard, OH 43026

5844 Darrow Rd
Hudson, OH 44236
Phone (330) 650-6767

700 Beta Dr
Ste 500R
Mayfield Village, OH 44143
Phone (440) 460-2488

574 N State St
Ste G
Westerville, OH 43082

550 S Canfield Niles Rd
Youngstown, OH 44515
Phone (330) 799-4446

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ohiohealth Rehabilitation HospitalColumbus, OH, CCN 363037 Hospital 5% Or Greater Indirect Ownership Interest (7.4%) Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Ohrh, LLC
    • Rehabilitation Hospital
    • Columbus, OH
    • NPI 1366785511

    5% Or Greater Indirect Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1689604084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HIGHLAND TERRACE BLVD",
            "address_2": "SUITE B",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444843074",
            "telephone_number": "330-652-8733",
            "fax_number": "330-652-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMR BANYAN TREE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.