NPIMap

Organization Active NPI

Mountain River Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Williamstown, WV
National Provider Identifier
1811594757
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MOUNTAIN RIVER PHYSICAL THERAPY, LLC
Practice address
108 Osprey Drive
Suite B
Williamstown, WV 26187
Phone
(304) 917-3660
Fax
(304) 917-3674
NPI assigned
Oct 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Krista Rogers
Title
Cfo/VP of Operations and Finance
Phone
(304) 865-6778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

108 Osprey Drive
Suite B
Williamstown, WV 26187

Mailing address

415 36TH St Ste 100
Parkersburg, WV 26101-1005
Phone (304) 917-3660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000524 WV Part B Supplier - Clinic/Group Practice 0547259335 Receives reassigned benefits from 19 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ripley, WV; Williamstown, WV; Wheeling, WV; Wellsburg, WV; Vienna, WV; Ravenswood, WV; Point Pleasant, WV; Parkersburg, WV…

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Locations

959 E State St
Athens, OH 45701
Phone (740) 593-6778

174 N State Route 2
#2
New Martinsville, WV 26155
Phone (304) 865-6778

2000 1st Ave
Parkersburg, WV 26101
Phone (304) 865-6778

2998 Charleston Rd
Ste 5
Ripley, WV 25271
Phone (304) 373-0093

841 Commerce St
Wellsburg, WV 26070
Phone (304) 737-0437

55 Lounez Ave
Wheeling, WV 26003
Phone (304) 905-0802

620 National Rd
Ste 100
Wheeling, WV 26003
Phone (304) 230-5601

108 Osprey Dr
Ste B
Williamstown, WV 26187
Phone (304) 917-3660

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1811594757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST STE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OSPREY DRIVE",
            "address_2": "SUITE B",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "26187",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIVER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "CFO/VP OF OPERATIONS AND FINANCE",
        "authorized_official_telephone_number": "304-865-6778"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.