Individual provider Active NPI

Justin Loring Weisbrod, PT

  • Physical Therapist
  • Gahanna, OH
National Provider Identifier
1750361499
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11056 Issued in OH
Practice address
1045 Beecher Xing N
Suite C
Gahanna, OH 43230-4573
Phone
(614) 775-9618
Fax
(614) 775-9633
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT11056 OH Primary

Addresses

Primary practice location

1045 Beecher Xing N
Suite C
Gahanna, OH 43230-4573

Mailing address

1045 Beecher Xing N
Suite C
Gahanna, OH 43230-4573
Phone (614) 775-9618

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091209000003 OH Practitioner - Physical Therapist in Private Practice 6103965801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT11056OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gahanna Physical Therapy Limited Partnership Physical Therapist CurrentSince Oct 1, 2009 Accepting new patients
Gahanna Physical Therapy Limited Partnership Physical Therapist Current Accepting new patients
Gahanna Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Gahanna Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Gahanna Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients

Locations

11945 Lithopolis Rd NW
Canal Wnchstr, OH 43110
Phone (614) 837-4381

3100 Plaza Properties Blvd
Ste 210
Columbus, OH 43219
Phone (614) 334-6434

1045 Beecher Xing N
Ste C
Gahanna, OH 43230
Phone (614) 775-9618

2000 Newark Granville Rd
Ste 203
Granville, OH 43023
Phone (740) 788-8100

1506 Hubbard Dr
Lancaster, OH 43130
Phone (740) 485-5489

1914 Tamarack Rd
Newark, OH 43055
Phone (740) 788-8100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1750361499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 BEECHER XING N",
            "address_2": "SUITE C",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432304573",
            "telephone_number": "614-775-9618",
            "fax_number": "614-775-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 BEECHER XING N",
            "address_2": "SUITE C",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432304573",
            "telephone_number": "614-775-9618",
            "fax_number": "614-775-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBROD",
        "first_name": "JUSTIN",
        "middle_name": "LORING",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT11056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.