NPIMap

Organization Active NPI

Orthopedic and Sports Physical Therapy Center, Inc

  • Physical Therapy Clinic/Center
  • Benton Harbor, MI
National Provider Identifier
1811908650
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
5501004651 Issued in MI
Legal business name
ORTHOPEDIC AND SPORTS PHYSICAL THERAPY CENTER, INC
Practice address
1850 Pipestone Rd
Suite 202
Benton Harbor, MI 49022-2304
Phone
(269) 925-9491
Fax
(269) 925-9553
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ricarthur Dano Lontoc, P.T.NPI 1881883791
Title
President/Physical Therapist
Phone
(269) 925-9491

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 Therapy Clinic/Center 261QP2000X 5501004651 MI Primary

Addresses

Primary practice location

1850 Pipestone Rd
Suite 202
Benton Harbor, MI 49022-2304

Mailing address

PO Box 8704
Benton Harbor, MI 49023-8704
Phone (269) 925-9491

Other identifiers 3

IdentifierTypeStateIssuer
64-30126OtherMIIBA/PHP PROVIDER NUBMER
479640MedicaidMI
305174OtherMICHP #, HEALTH PLAN MNGT

National Provider Directory

National Provider Directory

Locations

1850 Pipestone Rd
Ste 202A
Benton Harbor, MI 49022
Phone (269) 925-9491

1850 Pipestone Rd
Ste 202
Benton Harbor, MI 49022
Phone (269) 925-9491

Practitioners & affiliated clinicians

Practitioners 3

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811908650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8704",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490238704",
            "telephone_number": "269-925-9491",
            "fax_number": "269-925-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 PIPESTONE RD",
            "address_2": "SUITE 202",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222304",
            "telephone_number": "269-925-9491",
            "fax_number": "269-925-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC AND SPORTS PHYSICAL THERAPY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONTOC",
        "authorized_official_first_name": "RICARTHUR",
        "authorized_official_middle_name": "DANO",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "269-925-9491",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501004651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBA/PHP PROVIDER NUBMER",
            "identifier": "64-30126",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479640",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHP #, HEALTH PLAN MNGT",
            "identifier": "305174",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.