Nicholas Encheff
Individual provider Active NPI Physical Therapist · Northwood, OH
NPI 1902809890 · NPPES record last updated Mar 13, 2008
Key facts
- NPI
- 1902809890
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-05829 (OH)
- Practice address
- 4725 Woodville Rd
Ste 4
Northwood, OH 43619-1857 - Phone
- (419) 698-2500
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Summit Rehabilitation Services, LLC
Practice addresses (Care Compare)
3715 Williston Rd
Northwood, OH 43619-2001
Phone (419) 698-2500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131015001353 | OH | Practitioner - Physical Therapist in Private Practice | 3173593613 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-05829 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Rehabilitation Services, LLC | Physical Therapist | Current |
Accepting new patients |
| Prohab Physical Therapy East, LLC | Physical Therapist | Past | Accepting new patients |
Locations
3715 Williston Rd
Northwood, OH 43619
Phone (419) 698-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-05829 | OH | Yes |
Addresses
Primary practice location
4725 Woodville Rd
Ste 4
Northwood, OH 43619-1857
Mailing address
4725 Woodville Rd
Ste 4
Northwood, OH 43619-1857
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2616771 | Medicaid | OH | |
| 335268 | Other | OH | ANTHEM |
Other providers in Northwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.