Pediatric Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1046-0165 Issued in WV

Legal business name

PEDIATRIC PHYSICAL THERAPY, LLC

Practice address

RR 6 Box 260-6E
Fairmont, WV 26554-9396

Phone

(304) 367-0750

NPI assigned

Mar 25, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Nancy E Hickman, PT

Title

President

Phone

(304) 366-8395

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1332633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332633600000",
    "number": "1750657664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "COLFAX",
            "state": "WV",
            "postal_code": "265660088",
            "telephone_number": "304-367-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 6 BOX 260-6E",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265549396",
            "telephone_number": "304-367-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-25",
        "last_updated": "2012-03-25",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-366-8395",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "WV",
            "license": "1046-0165",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WV",
            "license": "1046-0165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Paul
• Jamika Payne-Collins
• Carrie Ann Pearl
• Leah M Peck, LGSW
• Pediatric Partners, PLLC
• Lauren Peet, DPT
• Leeann Marie Pellegrin
• Pelvic Care Physical Therapy
• Rachelle Marie Perkins
• Jodi Perozich

• Physical Therapy Clinic/Center in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Physical Therapy Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2012; 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.