NPIMap

Organization Active NPI

Keystone Rehabilitation Systems Inc

Doing business as Keystone Physical Therapy

  • Physical Therapy Clinic/Center
  • Boardman, OH
National Provider Identifier
1912229675
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
KEYSTONE REHABILITATION SYSTEMS INC
Doing business as
Keystone Physical Therapy
Practice address
910 Boardman Canfield Rd
Boardman, OH 44512-4218
Phone
(330) 758-4455
Fax
(330) 758-2055
NPI assigned
Feb 23, 2010
Last updated
Oct 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Authorized official

Name
Jayne Fleck Pool
Title
Chief Compliance Officer
Phone
(469) 467-8705

Specialties & licenses 1

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

Addresses

Primary practice location

910 Boardman Canfield Rd
Boardman, OH 44512-4218

Mailing address

PO Box 1245
Indiana, PA 15701-5245
Phone (724) 465-3496

Other names 1

  • Keystone Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000612 OH Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 7012826753 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mayfield Village, OH; Orwell, OH; Youngstown, OH

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1912229675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157015245",
            "telephone_number": "724-465-3496",
            "fax_number": "215-413-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124218",
            "telephone_number": "330-758-4455",
            "fax_number": "330-758-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE REHABILITATION SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "FLECK",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-467-8705"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.