NPIMap

Organization Active NPI

River Rock Rehabilitation, LLC

  • Physical Therapist
  • Marion, OH
National Provider Identifier
1689894461
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RIVER ROCK REHABILITATION, LLC
Practice address
990 S Prospect Street
Suite 4
Marion, OH 43302
Phone
(740) 387-2900
Fax
(740) 387-2922
NPI assigned
Apr 26, 2007
Last updated
May 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Mr. William Reinbolt, PTNPI 1215052501
Title
Vice President
Phone
(740) 387-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT02840 OH
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X OH Primary

Addresses

Primary practice location

990 S Prospect Street
Suite 4
Marion, OH 43302

Mailing address

990 South Prospect Street
Suite 4
Marion, OH 43302
Phone (740) 387-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070426000410 OH Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3779492186 Practice locations: Mansfield, OH; Toledo, OH; Marion, OH; Delaware, OH
O20241104002615 OH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779492186 Receives reassigned benefits from 23 practitioners
Practice locations: Warren, OH; Toledo, OH; Marysville, OH; Marion, OH; Mansfield, OH; Delaware, OH; Beachwood, OH; Akron, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689894461. Details of each certification follow.

  • CCN 366722 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 366722

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
RIVER ROCK REHABILITATION, LLC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Aug 25, 2003
Last certification
Mar 9, 2016
Ownership / control type
Proprietary
Facility address
990 South Prospect Street, Suite 4
Marion, OH 43302

National Provider Directory

National Provider Directory

Locations

630 Lexington Ave
Ste 6
Mansfield, OH 44907

990 S Prospect St
Ste 4
Marion, OH 43302
Phone (740) 387-2900

211 Stocksdale Dr
Ste C
Marysville, OH 43040
Phone (740) 383-3490

3840 Woodley Rd
Ste D
Toledo, OH 43606
Phone (419) 309-1240

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1689894461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SOUTH PROSPECT STREET",
            "address_2": "SUITE 4",
            "city": "MARION",
            "state": "OH",
            "postal_code": "43302",
            "telephone_number": "740-387-2900",
            "fax_number": "740-387-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 S PROSPECT STREET",
            "address_2": "SUITE 4",
            "city": "MARION",
            "state": "OH",
            "postal_code": "43302",
            "telephone_number": "740-387-2900",
            "fax_number": "740-387-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER ROCK REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "REINBOLT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "740-387-2900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT02840",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.