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Organization Active NPI

Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Peru, IN
National Provider Identifier
1750764494
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IVYREHAB PHYSICAL THERAPY, OCCUPATIONAL THERAPY & SPEECH LANGUAGE PATH
Practice address
5 Broadway PLZ
Peru, IN 46970-1052
Phone
(631) 580-5200
Fax
(631) 580-5222
NPI assigned
Jun 30, 2015
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
IVYREHAB PHYSICAL THERAPY, OCCUPATIONAL THERAPY & SPEECH LANGUAGE PATHOLOGY, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Ashley Griffiths
Title
Sr. Director of Provider Relations
Phone
(914) 294-4050

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Pediatric Physical Therapist 2251P0200X
Occupational Therapist 225X00000X
Pediatric Occupational Therapist 225XP0200X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

5 Broadway PLZ
Peru, IN 46970-1052

Mailing address

PO Box 416501
Boston, MA 02241-7594
Phone (914) 294-4050

Other names 3

  • IVYREHAB PHYSICAL THERAPY, PLLC Former legal business name
  • Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC Other name
  • Ivyrehab Physical Therapy, Occupational Therapy & Speech-Language Path Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151211000959 IN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7012997638 Receives reassigned benefits from 98 practitioners
Practice locations: Valparaiso, IN; Winfield, IN; Saint John, IN; Portage, IN; Peru, IN; Indianapolis, IN; Fishers, IN; Crown Point, IN…

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ivyrehab Physical Therapy Occupational Therapy Speech Language Path8 organizations share this tax ID, including this one
Part of
Ivyrehab Physical Therapy Occupational Therapy Speech Language Path

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11275 Delaware Pkwy
#B
Crown Point, IN 46307
Phone (219) 304-6074

11496 Broadway
Ste 150
Crown Point, IN 46307
Phone (219) 777-3306

9002 N Meridian St
Ste 111
Indianapolis, IN 46260
Phone (317) 779-3530

1805 E Hoffer St
Kokomo, IN 46902
Phone (765) 450-7261

5 Broadway Plz
Peru, IN 46970
Phone (765) 327-2111

10787 Randolph St
Ste 220
Winfield, IN 46307
Phone (219) 333-5900

Practitioners & affiliated clinicians

Practitioners 117

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.

View all 117

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1750764494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022417594",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BROADWAY PLZ",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701052",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYREHAB PHYSICAL THERAPY, OCCUPATIONAL THERAPY & SPEECH LANGUAGE PATH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IVYREHAB PHYSICAL THERAPY, OCCUPATIONAL THERAPY & SPEECH LANGUAGE PATHOLOGY, PLLC",
        "enumeration_date": "2015-06-30",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "GRIFFITHS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "SR. DIRECTOR OF PROVIDER RELATIONS",
        "authorized_official_telephone_number": "914-294-4050"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVYREHAB PHYSICAL THERAPY, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "IVYREHAB PHYSICAL THERAPY, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ivyrehab Physical Therapy, Occupational Therapy & Speech-Language Path",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peru, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.