NPIMap

Organization Active NPI

Advanced Rehabilitation and Health Specialists Inc

  • Physical Therapist
  • Mantua, OH
National Provider Identifier
1780763763
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3343 Issued in OH
Legal business name
ADVANCED REHABILITATION AND HEALTH SPECIALISTS INC
Practice address
4707 Mill Street
Mantua, OH 44255
Phone
(330) 274-2747
Fax
(330) 274-0337
NPI assigned
Nov 2, 2006
Last updated
Aug 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Dr. Edie Knowlton Benner, PH.D.NPI 1568535862
Title
Owner/Physical Therapist
Phone
(330) 274-2747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3343 OH Primary

Addresses

Primary practice location

4707 Mill Street
Mantua, OH 44255

Mailing address

4707 Mill St
Mantua, OH 44255-8934
Phone (330) 274-2747

Other identifiers 1

IdentifierTypeStateIssuer
2161922MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070905000103 OH Part B Supplier - Clinic/Group Practice 3678666807 Receives reassigned benefits from 4 practitioners
Practice locations: Mantua, OH
O20190402002283 OH MDPP Supplier - in-Person MDPP Supplier 3678666807 Practice locations: Mantua, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1780763763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 MILL ST",
            "city": "MANTUA",
            "state": "OH",
            "postal_code": "442558934",
            "telephone_number": "330-274-2747",
            "fax_number": "330-274-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 MILL STREET",
            "city": "MANTUA",
            "state": "OH",
            "postal_code": "44255",
            "telephone_number": "330-274-2747",
            "fax_number": "330-274-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REHABILITATION AND HEALTH SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "BENNER",
        "authorized_official_first_name": "EDIE",
        "authorized_official_middle_name": "KNOWLTON",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "330-274-2747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "3343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161922",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mantua, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.