NPIMap

Organization Active NPI

Park Rehab, Inc.

  • Geriatric Physical Therapist
  • Etna, OH
National Provider Identifier
1790981033
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
004514 Issued in OH
Legal business name
PARK REHAB, INC.
Practice address
14176 National Rd SW
Etna, OH 43068-3363
Phone
(740) 927-6782
NPI assigned
Jun 24, 2007
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Todd T Park, M.S., P.T.NPI 1730335621
Title
Pres
Phone
(740) 927-6782

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
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X 004514 OH Primary

Addresses

Primary practice location

14176 National Rd SW
Etna, OH 43068-3363

Mailing address

14176 National Rd SW
Etna, OH 43068-3363
Phone (740) 927-6782

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200504001478 OH Part B Supplier - Clinic/Group Practice 6901237155 Receives reassigned benefits from 7 practitioners
Practice locations: Etna, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1182643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1790981033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14176 NATIONAL RD SW",
            "city": "ETNA",
            "state": "OH",
            "postal_code": "430683363",
            "telephone_number": "740-927-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14176 NATIONAL RD SW",
            "city": "ETNA",
            "state": "OH",
            "postal_code": "430683363",
            "telephone_number": "740-927-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-24",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "740-927-6782",
        "authorized_official_credential": "M.S., P.T."
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "OH",
            "license": "004514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Etna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.