Organization Active NPI

Mountain Home Physical Therapy

  • Physical Therapist
  • Huntington, WV
National Provider Identifier
1730410101
Registry record updated Aug 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1507 Issued in WV
Legal business name
MOUNTAIN HOME PHYSICAL THERAPY
Practice address
1412 6TH Ave
Huntington, WV 25701-2421
Phone
(304) 523-4555
Fax
(304) 525-1736
NPI assigned
Jan 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2013

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

Authorized official

Name
Mr. Daryl Allen White, PHYSICAL THERAPIST
Title
President
Phone
(304) 523-4555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1507 WV Primary

Addresses

Primary practice location

1412 6TH Ave
Huntington, WV 25701-2421

Mailing address

1412 6TH Ave
Huntington, WV 25701-2421
Phone (304) 523-4555

Other names 1

  • Valley Ridge Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1412 6th Ave
Huntington, WV 25701
Phone (304) 523-4555

Practitioners & affiliated clinicians

Practitioners 3

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": "1264291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375574400000",
    "number": "1730410101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 6TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012421",
            "telephone_number": "304-523-4555",
            "fax_number": "304-525-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 6TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012421",
            "telephone_number": "304-523-4555",
            "fax_number": "304-525-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-24",
        "last_updated": "2013-08-04",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-523-4555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "1507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Ridge Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.