Organization Active NPI

Active Rehab Services Inc

Doing business as Active Recovery Physical Therapy

  • Physical Therapist
  • Oak Hill, WV
National Provider Identifier
1730162249
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVE REHAB SERVICES INC
Doing business as
Active Recovery Physical Therapy
Practice address
436 Central Ave
Oak Hill, WV 25901-3009
Phone
(304) 465-3654
Fax
(304) 465-8551
NPI assigned
Nov 29, 2005
Last updated
Feb 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Ms. Debra A Fragala
Title
Managing Director
Phone
(304) 465-3654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X WV Primary

Addresses

Primary practice location

436 Central Ave
Oak Hill, WV 25901-3009

Mailing address

436 Central Ave
Oak Hill, WV 25901-3009
Phone (304) 465-3654

Other identifiers 2

IdentifierTypeStateIssuer
001707473OtherWVMOUNTAIN STATE BC/BS
1043802OtherWVWV WORKERS COMPENSATION

Other names 1

  • Active Recovery Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000069 WV Part B Supplier - Clinic/Group Practice 1850374760 Receives reassigned benefits from 3 practitioners
Practice locations: Victor, WV; Oak Hill, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1730162249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CENTRAL AVE",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259013009",
            "telephone_number": "304-465-3654",
            "fax_number": "304-465-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CENTRAL AVE",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259013009",
            "telephone_number": "304-465-3654",
            "fax_number": "304-465-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE REHAB SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "FRAGALA",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "304-465-3654",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BC/BS",
            "identifier": "001707473",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMPENSATION",
            "identifier": "1043802",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Recovery Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Hill, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.