NPIMap

Organization Active NPI

Mountain River Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Point Pleasant, WV
National Provider Identifier
1720538200
Registry record updated Jan 16, 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
3407 Jackson Ave
Point Pleasant, WV 25550-1827
Phone
(304) 857-6532
Fax
(304) 857-6547
NPI assigned
Oct 10, 2016
Last updated
Jan 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 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

3407 Jackson Ave
Point Pleasant, WV 25550-1827

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

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484524800000",
    "number": "1720538200",
    "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": "3407 JACKSON AVE",
            "city": "POINT PLEASANT",
            "state": "WV",
            "postal_code": "255501827",
            "telephone_number": "304-857-6532",
            "fax_number": "304-857-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIVER PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2017-01-16",
        "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 Point Pleasant, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.