NPIMap

Organization Active NPI

Concorde Therapy Group, Inc.

  • Rehabilitation Clinic/Center
  • Canton, OH
National Provider Identifier
1780697656
Registry record updated May 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CONCORDE THERAPY GROUP, INC.
Practice address
4645 Belpar St NW
Canton, OH 44718-3602
Phone
(330) 493-4210
Fax
(330) 493-4744
NPI assigned
Aug 14, 2006
Last updated
May 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2021

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

Authorized official

Name
Mr. Mark D Mottice, PTNPI 1679594824
Title
President
Phone
(330) 493-4210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

4645 Belpar St NW
Canton, OH 44718-3602

Mailing address

4645 Belpar St NW
Canton, OH 44718-3602
Phone (330) 493-4210

Other identifiers 1

IdentifierTypeStateIssuer
0355949MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780697656. Details of each certification follow.

  • CCN 366577 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 366577

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
STARK COUNTY THERAPY ASSOCIATES INC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jul 2, 1989
Last certification
Nov 13, 2014
Ownership / control type
Proprietary
Facility address
4645 Belpar Street NW
Canton, OH 44718

National Provider Directory

National Provider Directory

Locations

6728 Whipple Nwave
Canton, OH 44720
Phone (330) 837-8888

513 E Main St
Louisville, OH 44641
Phone (330) 875-0888

6651 Frank Ave NW
Ste A
North Canton, OH 44720

Practitioners & affiliated clinicians

Practitioners 10

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": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621728000000",
    "number": "1780697656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183602",
            "telephone_number": "330-493-4210",
            "fax_number": "330-493-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 BELPAR ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183602",
            "telephone_number": "330-493-4210",
            "fax_number": "330-493-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDE THERAPY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "MOTTICE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-493-4210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0355949",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.