NPIMap

Organization Active NPI

X-Cel Performance Rehab LLC

  • Physical Rehabilitation Occupational Therapist
  • Ridgeley, WV
National Provider Identifier
1891168381
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
06809 Issued in MD
Legal business name
X-CEL PERFORMANCE REHAB LLC
Practice address
4767 Frankfort Highway
Ridgeley, WV 26753-7772
Phone
(301) 876-5892
NPI assigned
Nov 5, 2015
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Karen Shambaugh, OTRNPI 1295002111
Title
Owner
Phone
(301) 876-5892

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 Rehabilitation Occupational Therapist 225XP0019X 06809 MD Primary

Addresses

Primary practice location

4767 Frankfort Highway
Ridgeley, WV 26753-7772

Mailing address

4767 Frankfort Highway
Ridgeley, WV 26753-7772

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160404000561 WV Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6608173877 Receives reassigned benefits from 9 practitioners
Practice locations: Ridgeley, WV

National Provider Directory

National Provider Directory

Locations

500 E Main St
Ste C
Romney, WV 26757
Phone (304) 359-2345

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1891168381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4767 FRANKFORT HIGHWAY",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267537772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4767 FRANKFORT HIGHWAY",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267537772",
            "telephone_number": "301-876-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "X-CEL PERFORMANCE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "SHAMBAUGH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-876-5892",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MD",
            "license": "06809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.