Maranatha Family Center, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006533-1 Issued in NY

Legal business name

MARANATHA FAMILY CENTER, LLC

Practice address

1461 State Route 7
Richmondville, NY 12149-2305

Phone

(518) 234-2868

Fax

(518) 254-7050

NPI assigned

Aug 8, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Stella T McKenna, PT

Title

Owner/ Physical Therapist

Phone

(518) 234-2868

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Stella Theresa Way, PT

  • Physical Therapist
  • Anderson, SC
  • NPI 1992767123
  NPD

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1710319082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 STATE ROUTE 7",
            "city": "RICHMONDVILLE",
            "state": "NY",
            "postal_code": "121492305",
            "telephone_number": "518-234-2868",
            "fax_number": "518-254-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 STATE ROUTE 7",
            "city": "RICHMONDVILLE",
            "state": "NY",
            "postal_code": "121492305",
            "telephone_number": "518-234-2868",
            "fax_number": "518-254-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANATHA FAMILY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/ PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "518-234-2868",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "006533-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01358983",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omar M. Alwakfi, D.M.D.
• Jessica Lynn Chichester, LPN
• Kelly Lyn Grant, M.S.ED, CCC-SLP
• Karalee Johnson, DPT
• Kathleen Erica Kelly
• Northland Hearing Center, Inc.
• Northland Hearing Centers, Inc.
• Precision Physical Therapy and Sports Medicine PLLC
• Richmondville Family Dental Practice, PLLC.
• Richmondville Volunteer Emergency Squad Inc

• Physical Therapist in Richmondville, NY
• Providers in Richmondville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.