NPIMap

Organization Active NPI

Motive Sports and Physical Therapy Malvern, LLC

  • Physical Therapist
  • Frazer, PA
National Provider Identifier
1871354159
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOTIVE SPORTS AND PHYSICAL THERAPY MALVERN, LLC
Practice address
480 Lancaster Ave Ste 4
Frazer, PA 19355-1834
Phone
(610) 500-5296
Fax
(484) 359-0098
NPI assigned
Jan 23, 2024
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Mark Worrilow, DPTNPI 1689073207
Title
Owner
Phone
(610) 500-5296

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 Therapist 225100000X Primary

Addresses

Primary practice location

480 Lancaster Ave Ste 4
Frazer, PA 19355-1834

Mailing address

540 Hopewell St
Birdsboro, PA 19508-2657
Phone (610) 500-5296

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241010002670 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7113459587 Receives reassigned benefits from 19 practitioners
Practice locations: Berwyn, PA; Frazer, PA; Media, PA; West Chester, PA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1175 Lancaster Ave
Ste 100
Berwyn, PA 19312
Phone (484) 583-4113

480 Lancaster Ave
Ste 4
Frazer, PA 19355
Phone (610) 500-5296

480 Lancaster Ave
Unit 4
Malvern, PA 19355
Phone (610) 500-5296

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1871354159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 HOPEWELL ST",
            "city": "BIRDSBORO",
            "state": "PA",
            "postal_code": "195082657",
            "telephone_number": "610-500-5296",
            "fax_number": "484-359-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 LANCASTER AVE STE 4",
            "city": "FRAZER",
            "state": "PA",
            "postal_code": "193551834",
            "telephone_number": "610-500-5296",
            "fax_number": "484-359-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTIVE SPORTS AND PHYSICAL THERAPY MALVERN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "WORRILOW",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-500-5296",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frazer, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.