NPIMap

Organization Active NPI

Professional Physical Therapy Services, Inc

  • Physical Therapist
  • Mason, OH
National Provider Identifier
1790804326
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL PHYSICAL THERAPY SERVICES, INC
Practice address
5700 Gateway
Suite 100a
Mason, OH 45040-1890
Phone
(513) 336-0540
Fax
(513) 336-6064
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Eric Z Novicki, A.T.C.NPI 1629415690
Title
President
Phone
(513) 671-5841

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X OH Primary

Addresses

Primary practice location

5700 Gateway
Suite 100a
Mason, OH 45040-1890

Mailing address

11729 Springfield Pike
Cincinnati, OH 45246-2311
Phone (513) 671-5841

Other identifiers 1

IdentifierTypeStateIssuer
2927293MedicaidOH

Other names 1

  • SPORTS THERAPY, INC Doing business as

National Provider Directory

National Provider Directory

Locations

1060 Nimitzview Dr
Ste 205
Cincinnati, OH 45230
Phone (513) 474-8600

11729 Springfield Pike
Cincinnati, OH 45246
Phone (513) 671-0900

8240 Northcreek Dr
Ste 4100
Cincinnati, OH 45236
Phone (513) 463-2518

4464 Indian Ripple Rd
Dayton, OH 45440
Phone (937) 426-1120

7450 S Mason Montgomery Rd
#105
Mason, OH 45040
Phone (513) 336-0540

7759 University Dr
West Chester, OH 45069
Phone (513) 463-2518

7060 Ridgetop Dr
West Chester, OH 45069
Phone (513) 463-2518

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790804326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11729 SPRINGFIELD PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452462311",
            "telephone_number": "513-671-5841",
            "fax_number": "513-671-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 GATEWAY",
            "address_2": "SUITE 100A",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401890",
            "telephone_number": "513-336-0540",
            "fax_number": "513-336-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHYSICAL THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NOVICKI",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-671-5841",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "A.T.C."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2927293",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPORTS THERAPY, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.