NPIMap

Organization Active NPI

Braddock Physical Therapy & Rehabilitation, Inc.

  • Physical Therapist
  • Beaver Falls, PA
National Provider Identifier
1700907938
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BRADDOCK PHYSICAL THERAPY & REHABILITATION, INC.
Practice address
1008 7TH Ave Ste 205
Beaver Falls, PA 15010
Phone
(724) 846-5887
Fax
(724) 436-7200
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
Edward Roy Braddock, PTNPI 1497707228
Title
President
Phone
(724) 846-5887

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1008 7TH Ave Ste 205
Beaver Falls, PA 15010

Mailing address

1008 7TH Ave Ste 205
Beaver Falls, PA 15010-4558
Phone (724) 846-5887

Other practice location 1

48462 Bell School Rd
Suite D
East Liverpool, OH 43920-9625
Phone (330) 385-5707

Other practice location 2

124 Loughridge Dr
Beaver Falls, PA 15010-1422
Phone (724) 846-5887

Other identifiers 1

IdentifierTypeStateIssuer
001784776OtherPAHIGHMARK GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000178 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3072569862 Receives reassigned benefits from 2 practitioners
Practice locations: Beaver Falls, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1700907938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 7TH AVE STE 205",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "150104558",
            "telephone_number": "724-846-5887",
            "fax_number": "724-436-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 7TH AVE STE 205",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "15010",
            "telephone_number": "724-846-5887",
            "fax_number": "724-436-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48462 Bell School Rd",
            "address_2": "Suite D",
            "address_purpose": "LOCATION",
            "city": "East Liverpool",
            "state": "OH",
            "postal_code": "439209625",
            "country_code": "US",
            "telephone_number": "330-385-5707",
            "fax_number": "330-382-7353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 Loughridge Dr",
            "address_purpose": "LOCATION",
            "city": "Beaver Falls",
            "state": "PA",
            "postal_code": "150101422",
            "country_code": "US",
            "telephone_number": "724-846-5887",
            "fax_number": "724-436-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRADDOCK PHYSICAL THERAPY & REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "BRADDOCK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-846-5887",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK GROUP",
            "identifier": "001784776",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Falls, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.