Portage Physical Therapists, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PORTAGE PHYSICAL THERAPISTS, INC

Doing business as

Allied Health Rehab

Practice address

35 N Cleveland Ave
Ste C
Mogadore, OH 44260-1365

Phone

(330) 628-0736

Fax

(330) 628-0739

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Darbie Ferrara-Mathys

Title

C.E.O.

Phone

(330) 297-9020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Allied Health Rehab Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 366730

Legal name

ALLIED HEALTH REHAB CENTERS

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Dec 2, 2004

Last certification

May 1, 2018

Ownership / control type

Proprietary

Facility address

35 North Cleveland Avenue
Mogadore, OH 44260

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1790820355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 N FREEDOM ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662470",
            "telephone_number": "330-297-9020",
            "fax_number": "330-297-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 N CLEVELAND AVE",
            "address_2": "STE C",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442601365",
            "telephone_number": "330-628-0736",
            "fax_number": "330-628-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PHYSICAL THERAPISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "FERRARA-MATHYS",
        "authorized_official_first_name": "DARBIE",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "330-297-9020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2955306",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allied Health Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Mogadore, OH
• Providers in Mogadore, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.